Sent 02/23/2026 12:10:21, Page - 9

FRASER HEALTH AUTHORITY Emerg Note
Royal Columbian Hospital HOLAND,MARK THOMAS

RC0430440/25

LIs patient currently pregnant? | No

Glasgow Coma Scale total saore | 15/15 25/01/2026 22:40
Glasgow Coma Scale total score | 15/15 25/01/2026 la:4i

| Temperature 37.1 C |

Temperature Source | oral

Pulse Rate 76 25/01/2026 16:41
Resplratory Rate 16 25/01/2026 16:41

Blood Pressure
jood Pressure Mean

25/01/2026 16:41

Documentation

Mark is a 47 year old male who presents ta the emergency department with bilateral ear discomfort
over the last 2 days. He currently feels like it is worse on the left compared to the right. He feels as
though his symptoms have been worsening due to some noise exposure at his work place. Over the
last 2 weeks, he is in a classroom environment where he is sitting close ta some loud machinery. He
has not had any fever or sick symptoms, He has not suffered any trauma or injuries. He has no
discharge from the ears. He has not had any significant hearing loss.

Past medical history: Migralnes

On examination, he appears very well, His vital signs are norrnal. There Is no facial swelling nor
erythema. His bilateral tympanic membranes are clear. The canals are not edernatous nor
erythematous. There is no mastoid tenderness. His neck is supple with no lymphadenopathy. I do
not see any worrisome features suggestive of fracture or infection. May be having some strain

related to the warkplace environment. I have suggested audiology testing and family physician
follow-up.

Discharge Plan

This record contains conTdential Information which must be protected. Any unauthorized use or disclosure Is strictly prohibited.

Meditach Report ID: 2501-00357 203

PAGE 9/47 * RCVD AT 2/23/2026 12:10:26 PM [Pacific Standard Time] * SVR:FAXP21/3 * DNIS:9777 * CSID: * ANI:17783680130 * DURATION (mm-ss):21-27