Mar 12, 2026 11:58 To: +16042339777 Page: 32/46 From: Foremed Medical Clinic
FRASER HEALTH AUTHORITY Emerg Note
Royal Columbian Hospital HOLAND,MARK THOMAS
RC0430440/25

Fax: 16043985614

Ie patient currently pregnant? | No

_Glasgow Coma Scale total score | 15/15 | 25/03/2026 22:40 |
Glasgow Coma Scale total score i 15/15 i BS/01/2026 16:41 |
_ Temperature | 37.1 Cj 25/01/2026 i
_ Temperature Source | oral {25/01/2026 /

_ Pulse Rate | 76 | 25/01/2026
Respiratory Rate 16 (25/01/2026
Blood Pressure | 126/83 { 25/01/2026 : i
Blood Pressure Mean | 97 | 25/01/2026 16:

Pulse Oximetry 1 98 i 25/01/2026 i

Documentation

Mark is a 47 year old male who presents to the emergency department with bilateral ear discomfort
over the fast 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
Jast 2 weeks, he is in a classroom environment where he is sitting close to 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 toss.

Past medical history: Migraines

On examination, he appears very well. His vital signs are normal. There is no facial swelling nor
erythema, His bilateral tympanic membranes are clear. The canals are not edematous nor
erythematous. There is no mastoid tenderness. His neck is supple with no lymphadenopathy. Ido
not see any worrisome features suggestive of fracture or infection. May be having some strain
related to the workplace environment. I have suggested audiology testing and family physician
follow-up.

Discharge Plan

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

Meditech Report !D: 2501-00357 20f3

PAGE 32/46 * RCVD AT 3/12/2026 11:59:36 AM [Pacific Daylight Time] * SVR:FAXP21/12 * DNIS:9777 * CSID:16043985614 * ANI:6043985614 * DURATION (m