--- a +++ b/data/text/Van_MacGyver_ce9f4463-d048-cc81-411a-58ae17855d1a.txt @@ -0,0 +1,186 @@ +Van MacGyver +============ +Race: Asian +Ethnicity: Non-Hispanic +Gender: F +Age: 10 +Birth Date: 2012-03-11 +Marital Status: S +-------------------------------------------------------------------------------- +ALLERGIES: + 2013-01-16 - : Cow's milk (substance) + 2013-01-16 - : Lisinopril + 2013-01-16 - : Tree pollen (substance) + 2013-01-16 - : Grass pollen (substance) + 2013-01-16 - : Animal dander (substance) + 2013-01-16 - : House dust mite (organism) + 2013-01-16 - : Mold (organism) + 2013-01-16 - : Latex (substance) +-------------------------------------------------------------------------------- +MEDICATIONS: + 2022-03-20[CURRENT] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2022-03-20[CURRENT] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2022-01-23[STOPPED] : Acetaminophen 160 MG Chewable Tablet + 2021-03-14[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2021-03-14[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2020-03-08[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2020-03-08[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2019-03-03[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2019-03-03[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2018-02-25[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2018-02-25[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2017-06-11[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2017-06-11[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2017-02-19[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2017-02-19[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2016-02-14[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2016-02-14[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2015-08-16[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2015-08-16[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2015-02-15[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2015-02-15[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2014-11-09[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2014-11-09[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2014-08-17[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2014-08-17[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2014-06-13[STOPPED] : NDA021457 200 ACTUAT albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [ProAir] for Childhood asthma + 2014-06-13[STOPPED] : 120 ACTUAT fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] for Childhood asthma + 2013-01-16[CURRENT] : NDA020800 0.3 ML Epinephrine 1 MG/ML Auto-Injector + 2013-01-16[CURRENT] : cetirizine hydrochloride 5 MG Oral Tablet +-------------------------------------------------------------------------------- +CONDITIONS: + 2022-01-23 - 2022-02-12 : Facial laceration + 2021-01-18 - 2021-09-17 : Child attention deficit disorder + 2021-01-11 - 2021-02-17 : COVID-19 + 2021-01-11 - 2021-01-11 : Suspected COVID-19 + 2021-01-11 - 2021-02-17 : Joint pain (finding) + 2021-01-11 - 2021-02-17 : Muscle pain (finding) + 2021-01-11 - 2021-02-17 : Sore throat symptom (finding) + 2021-01-11 - 2021-02-17 : Cough (finding) + 2014-06-13 - : Childhood asthma +-------------------------------------------------------------------------------- +CARE PLANS: + 2022-01-23[STOPPED] : Wound care + Reason: Facial laceration + Activity: Dressing change management + Activity: Behavior to prevent infection + 2021-01-18[STOPPED] : Overactivity/inattention behavior management + Activity: Counseling + Activity: Psychological assessment + 2021-01-11[STOPPED] : Infectious disease care plan (record artifact) + Activity: Airborne precautions (procedure) + Activity: Isolation of infected patient (procedure) + 2021-01-11[STOPPED] : Infectious disease care plan (record artifact) + Activity: Airborne precautions (procedure) + Activity: Personal protective equipment (physical object) + 2014-06-13[CURRENT] : Asthma self management + Reason: Childhood asthma + Activity: Inhaled steroid therapy + Activity: Home nebulizer therapy + Activity: Breathing control + 2013-01-03[CURRENT] : Self-care interventions (procedure) + Activity: Food allergy diet + Activity: Allergy education + Activity: Allergy education +-------------------------------------------------------------------------------- +REPORTS: + 2021-01-11 : SARS-CoV-2 RNA Pnl Resp NAA+probe + - SARS-CoV-2 RNA Pnl Resp NAA+probe Detected (qualifier value) + 2021-01-11 : Respiratory pathogens DNA and RNA panel - Respiratory specimen by NAA with probe detection + - Influenza virus A RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Influenza virus B RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Respiratory syncytial virus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Parainfluenza virus 1 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Parainfluenza virus 2 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Parainfluenza virus 3 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Rhinovirus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Human metapneumovirus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + - Adenovirus A+B+C+D+E DNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) +-------------------------------------------------------------------------------- +OBSERVATIONS: + 2022-03-20 : Tobacco smoking status Never smoked tobacco (finding) + 2022-03-20 : Respiratory rate 15.0 /min + 2022-03-20 : Heart rate 85.0 /min + 2022-03-20 : Blood Pressure + - Diastolic Blood Pressure 72.0 mm[Hg] + - Systolic Blood Pressure 130.0 mm[Hg] + 2022-03-20 : Body mass index (BMI) [Percentile] Per age and gender 66.4 % + 2022-03-20 : Body Mass Index 17.9 kg/m2 + 2022-03-20 : Body Weight 30.5 kg + 2022-03-20 : Pain severity - 0-10 verbal numeric rating [Score] - Reported 1.0 {score} + 2022-03-20 : Body Height 130.5 cm + 2021-03-14 : Tobacco smoking status Never smoked tobacco (finding) + 2021-03-14 : Respiratory rate 14.0 /min + 2021-03-14 : Heart rate 69.0 /min + 2021-03-14 : Blood Pressure + - Diastolic Blood Pressure 77.0 mm[Hg] + - Systolic Blood Pressure 114.0 mm[Hg] + 2021-03-14 : Body mass index (BMI) [Percentile] Per age and gender 71.0 % + 2021-03-14 : Body Mass Index 17.6 kg/m2 + 2021-03-14 : Body Weight 28.0 kg + 2021-03-14 : Pain severity - 0-10 verbal numeric rating [Score] - Reported 2.0 {score} + 2021-03-14 : Body Height 126.0 cm + 2021-01-11 : SARS-CoV-2 RNA Pnl Resp NAA+probe Detected (qualifier value) + 2021-01-11 : Adenovirus A+B+C+D+E DNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Human metapneumovirus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Rhinovirus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Parainfluenza virus 3 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Parainfluenza virus 2 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Parainfluenza virus 1 RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Respiratory syncytial virus RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Influenza virus B RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Influenza virus A RNA [Presence] in Respiratory specimen by NAA with probe detection Negative (qualifier value) + 2021-01-11 : Body Weight 27.3 kg + 2021-01-11 : Blood Pressure + - Diastolic Blood Pressure 73.0 mm[Hg] + - Systolic Blood Pressure 123.0 mm[Hg] + 2021-01-11 : Oxygen saturation in Arterial blood 75.5 % + 2021-01-11 : Heart rate 69.5 /min + 2021-01-11 : Respiratory rate 26.5 /min + 2021-01-11 : Body temperature 41.0 Cel +-------------------------------------------------------------------------------- +PROCEDURES: + 2022-01-23 : Suture open wound for Facial laceration + 2021-09-17 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-08-09 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-06-29 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-05-29 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-04-19 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-03-20 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-03-14 : Medication Reconciliation (procedure) + 2021-02-20 : Cognitive and behavioral therapy for Child attention deficit disorder + 2021-01-11 : Face mask (physical object) for Suspected COVID-19 +-------------------------------------------------------------------------------- +IMMUNIZATIONS: + 2022-03-20 : Influenza, seasonal, injectable, preservative free + 2021-03-14 : Influenza, seasonal, injectable, preservative free +-------------------------------------------------------------------------------- +ENCOUNTERS: +2022-03-20 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2022-01-23 (Dr. Burton Schoen) : Encounter at EXCEL HOME CARE SERVICES INC +2021-09-17 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-08-09 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-06-29 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-05-29 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-04-19 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-03-20 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-03-14 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2021-02-20 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-01-18 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Child attention deficit disorder +2021-01-11 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS +2020-03-08 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2019-03-03 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2018-02-25 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2017-06-10 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Viral sinusitis (disorder) +2017-02-19 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2016-02-14 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2015-08-16 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2015-02-15 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2014-11-09 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS +2014-08-17 (Dr. Quentin Fritsch) : Encounter at RIVER'S EDGE PRIMARY CARE LLC +2014-06-13 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS : Encounter for Childhood asthma +2013-01-16 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS +2013-01-03 (Dr. Cletus Paucek) : Encounter at ENCOMPASS HEALTH REHAB HOSPITAL OF WESTERN MASS +-------------------------------------------------------------------------------- +IMAGING STUDIES: +--------------------------------------------------------------------------------