chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic left ventricular failure, Chronic obstructive pulmonary disease, Computerised tomogram head normal, Condition aggravated
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Confusional state, Cough, Dyspnoea, Dyspnoea exertional, Endotracheal intubation
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Extubation, Feeding tube user, Fibrin D dimer increased, Gastrointestinal tube insertion, Hypotension
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Imaging procedure, Influenza, Intensive care, Laboratory test, Lung carcinoma cell type unspecified recurrent
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, Oxygen saturation decreased, Pneumonia, Pulmonary oedema, Refusal of treatment by patient
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Sputum culture, Staphylococcus test positive, Substance use
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Transfusion
Clinical narrative: Narrative: 12/24/2022 - Pt presented to ED with increased SOB after taking CBD gummies (stopped 3 days ago), wife reports pt seems off . Pt moving slowly, SOB with exertion - currently on oxygen 3L/min via nasal cannula at home. HPI: Patient presents to the ER via EMS for several day history of increasing shortness of breath and weakness. Patient states his sats were dropping into the 60s. Patient is on home O2 for history of lung cancer and a right-sided lobectomy as well as COPD. He reports that his normal chronic cough. Patient states he is extremely short of breath when he tries to ambulate. He denies any new chest pain, nausea or vomiting, abdominal pain or any other medical concerns. He also has an extensive cardiac history as well. MEDICAL DECISION MAKING (MDM): Patient with shortness of breath and especially a drop in sats when off his oxygen. Will initiate a cardiac work-up as well as chest x-ray. Patient history of COPD will give some steroids and nebulizers as well. Differential diagnosis includes, but not limited to, COPD, pneumonia, Covid, flu, ACS, PE, reoccurrence of lung CA. ER course-patient continued to drop his sats and became a little bit more confused/combative during his stay. He refused a blood gas. ICU MD was consulted and is currently here at 2300 to see the patient. Pt admitted to hospital 12/24/22 at 23:56 with principal diagnosis = acute on chronic hypercarbic respiratory failure secondary to COVID pneumonia. Pt hospital stay 12/24 - 12/30/22. ADDITIONAL DIAGNOSES: Chronic systolic congestive heart failure Chronic obstructive pulmonary disease exacerbation COVID viral pneumonia HOSPITAL COURSE: Pt required admission to MICU, subsequently patient was emergently intubated for airway control (in setting of acute hypoxic hypercarbic respiratory failure). PaCO2 on admission was 156. CT head obtained and found negative for intracranial bleed/swelling or abnormality. S/p cxr suggestive of bilateral infiltrates - covid vs pulm edema. Elevated D-dimer. ABG ordered in ED but pt refused, later obtained after intubation. Profound hypotension continued and required the initiation of levophed drip for control. Other related interventions initiated; Abtx (initiated with IV Ceftriazone & IV Zithromax -> then Vanc added), ABG pH 7.0, screening labs & imaging, central line placed, blood and sputum culture, NGT plcmt, tube feed, foley, dexamethasone, oral baricitinib started after CTA Chest confirmed negative PE/+ diffuse right upper lobe infiltrate, blood transfusion, and specialty consults (i.e. ID, Pulm, etc). S/p blood cultures - 1 set on 12/24, 1 set on 12/25, and 2 sets on 12/27 (results + Staphylococcus capitis from bld culture set obtained on 12/25)and C&S induced sputum was negative. Patient has been weaned off all drips, extubated on 2-3LNC, foley removed and medically cleared for transfer to medical-surgical unit. Pt discharged on 12/30/2022.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase normal, Allen's test, Anion gap, Aspartate aminotransferase normal, Asthenia
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Base excess decreased, Basophil count decreased, Benign prostatic hyperplasia, Bilirubin urine, Blood albumin decreased
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase normal, Blood bicarbonate decreased, Blood bilirubin increased, Blood calcium decreased, Blood chloride normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood pH increased, Blood potassium normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Blood urea normal, Blood urine present, COVID-19, Carbon dioxide decreased, Chest pain
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Corrective lens user, Decreased appetite, Dementia, Eosinophil count decreased
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Eosinophil percentage decreased, Fatigue, Glomerular filtration rate normal, Glucose urine absent, Granulocyte count
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Granulocyte percentage, Haematocrit decreased, Haemoglobin decreased, Hearing aid user, Hyperlipidaemia
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoacusis, Hyponatraemia, Hypoxia, Influenza A virus test negative, Loss of personal independence in daily activities
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Mean platelet volume normal, Monocyte count increased, Monocyte percentage increased, Nitrite urine absent, Normocytic anaemia
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Oxygen consumption, PCO2 decreased, PO2 decreased, Pallor, Platelet count normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Protein total decreased, Protein urine absent, Pulmonary imaging procedure abnormal, Purulent discharge, Red blood cell count decreased
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Red cell distribution width increased, Respiratory syncytial virus test negative, Respiratory tract congestion, SARS-CoV-2 test positive, Specific gravity urine normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin I normal, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine, White blood cell count normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cells urine negative, Wound secretion, pH urine normal
Clinical narrative: Narrative: 12/15/22 - Pt with a medical history of hyperlipidemia, history of TIA, spinal stenosis, suspected GCA (negative biopsy, on steroids), plantar fascial fibromatosis, tobacco abuse who presents to the ED complaining of increased fatigue, weakness x 1 week, decline in appetite, and purulent draining hand wound. Chills noted today. Pt also reports left sided chest pain. Wife noted Pt had acute onset of congestion, he is pale, and not performing his ADLs as usual (onset within past 24hrs). Pt tested COVID+ and was admitted to hospital 12/15/22 (with discharge on 12/29/22). PRINCIPAL DIAGNOSIS (Reason for admission after study): covid 19 with hypoxia ADDITIONAL DIAGNOSES: dementia ,chronic benign prostatic hypertrophy hyperlipidemia mild normocytic anemia mild hyponatremia hard of hearing. HOSPITAL COURSE: Pt admitted to the floor. dx covid with hypoxia. pt started on steroids. cont supplemental oxygen. pt monitored. did not need oxygen the next day. pt hearing aids and glasses at home. PT eval done and recs were 24/7 care at home. wife currently on chemo and unable to provide this. ppd placed. pt started on remdesivir by pharm d on 12/22. pt also restarted on steroids. pt completed 3 days of remdesivir and 7 days of dexamethasone. pt tolerated medications. pt communication improved with use of amplifyer. pt completed 10 days of isolation. sws working on STR for pt. due to abnormal imaging pulm consulted - will try wixella and triotropium due concern for underlying pulm ds. pt stable for discharged 12/29/22.