CCS helps needed!!!

[fungusflu]

Hi

I'm really confused about this whole CCS things. I have several questions

1. If the computer only said "you have 5 min before cases ends" only at the last minute (i.e. 20 min real time), does that mean I screwed up somewhere?

2. When the computer said "you have 5 min before cases ends" but my patient is still in the hospital (ward, ICU, ED), do i write my final order as if they'll stay in hospital or if they're going home? Also, does it matter if I haven't get around to send a stable patient home (because I want to monitor them for 1-2 days more or finish the course of IV Abx) when the case ends?

3. Would you transfer patient from ED right to ICU after you've ordered all the urgern Tx and investigations even if the patient is still symptomatic (i.e. still having chest pain, O2 sat still low ect)?

Thank you so much for all your help!

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[fungusflu]

I took the exam in the end of Nov, 2008 and just got my result last week and PASSED! I actually did really well in the CCS component so I thought I might share what I ended up doing since no one wrote a reply yet.

1. If you run off of the real time before case ends, you probably miss something crucial such that the case can't end sooner (the case will end when you did all the necessary order/intervention) so yeah, not a good sign.

2. I left the final order as if the patient is still in the hospital if I haven't discharge him/her before the case ends, I just delete all the intervention/monitoring that's no longer needed (e.g. EKG q 8 h, vital q 6 h, IV ect) and order all the counselling I haven't done yet (I always counsel patient on diagnosis and med side-effect, smoking cessation, exercise, limit EtOH, wear seatbelt, safe sex even not indicated just to make sure I score all the points). I also order follow-up tests/appointment if applicable (e.g. US for pregnant women).

3. I'd transfer unstable patient to ICU right after I've order all the urgent Tx and investigation, but I'd examine patient before that to make sure my urgent Tx is working (e.g. COPDer should respond to O2 Tx even though the O2 sat may still be low).

Hope this helps and best of luck to you all!

 

[marshmallows]

I took the exam in the end of Nov, 2008 and just got my result last week and PASSED! I actually did really well in the CCS component so I thought I might share what I ended up doing since no one wrote a reply yet.

1. If you run off of the real time before case ends, you probably miss something crucial such that the case can't end sooner (the case will end when you did all the necessary order/intervention) so yeah, not a good sign.

2. I left the final order as if the patient is still in the hospital if I haven't discharge him/her before the case ends, I just delete all the intervention/monitoring that's no longer needed (e.g. EKG q 8 h, vital q 6 h, IV ect) and order all the counselling I haven't done yet (I always counsel patient on diagnosis and med side-effect, smoking cessation, exercise, limit EtOH, wear seatbelt, safe sex even not indicated just to make sure I score all the points). I also order follow-up tests/appointment if applicable (e.g. US for pregnant women).

3. I'd transfer unstable patient to ICU right after I've order all the urgent Tx and investigation, but I'd examine patient before that to make sure my urgent Tx is working (e.g. COPDer should respond to O2 Tx even though the O2 sat may still be low).

Hope this helps and best of luck to you all!

thanks, thats good info. . what did you do to practice cases for ccs mainly? I am deciding to buy UW or steps 123, or just FA and usmle CD?
thanks