Step 3 CCS logistical help

[makesomerheum]

After looking over the review CCS CD, I came up with some questions.

1. What is the best way to get vital signs for an unstable patient? I typically add a cardiac monitor, BP monitor, pulse ox. Is it true you can only get vital signs to be repeated q 1hr? Do you just go and write another order for vital signs if need a repeat to see if pt improving?

2. How do you give treatment as an outpatient for a particular length of time? In the practice ITP case, I palced the patient on steroids and had them follow up but how do I know when to dc the treatment?

3. For a routine office visit for a stable patient, do you order STAT labs so you get the results back quickly before the patient leaves and has to make a follow up for the results?

4. If someone reports any alcohol use at all, do you counsel on alcohol?

Thanks for your help.

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[NuMD97]

After looking over the review CCS CD, I came up with some questions.

1. What is the best way to get vital signs for an unstable patient? I typically add a cardiac monitor, BP monitor, pulse ox. Is it true you can only get vital signs to be repeated q 1hr? Do you just go and write another order for vital signs if need a repeat to see if pt improving?

2. How do you give treatment as an outpatient for a particular length of time? In the practice ITP case, I palced the patient on steroids and had them follow up but how do I know when to dc the treatment?

3. For a routine office visit for a stable patient, do you order STAT labs so you get the results back quickly before the patient leaves and has to make a follow up for the results?

4. If someone reports any alcohol use at all, do you counsel on alcohol?

Thanks for your help.

Concerning the following:

(1) Once setting up the items you mention above, the program tells you that if you want a recheck, it says to order it as such. It's pretty straightforward. Judging from your question, you need to practice some more. The program is a tad tricky and one does need to practice with the CD as many other posters have already noted.

(2) Concerning treatment in general: The case will notify you as you progress how the patient is doing with popup notices. How long you treat the patient is a judgment call based on standards of care for whatever entity is being treated.

(3) Do NOT arbitrarily order things STAT if there is no need. That alone can cost you points. Suggestion: Invest in the USMLEWorld 47 new interactive cases (no, I don't get a commission). It really spells out for you specifically when certain interventions are appropriate/not appropriate or neutral for those cases. And very well constructed, I might add.

(4) If alcohol is mentioned, you counsel alcohol. Keep in mind that you are a "primary care physician" and all that you would normally do for a clinical patient is done here for the CCS.

I hope this is of some help for you. Good luck!

Nu