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  #1  
Old 08-21-2012
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Question CCS; Ordering tests and changing patient location

So, when I'm practicing CCS cases I'm a little bit confused.
Do I have to order a test and then wait for the result, then order the next one and so on? Because if I do something withouth seeing the result, it could be a penalty?
Also, once the window shows up saying that you only have 2 min left over, you can't change the location of the patient, right? How do I know then the time is up (there's no clock in the material as far as I can see)?
And, if I want a treatment to be for a specific number of days, I can't put that in, do I have to make an appointment for the patient in like say 7 days to stop his antibiotics?! Seems weird.
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Old 08-21-2012
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Quote:
Originally Posted by dr_mhm View Post
So, when I'm practicing CCS cases I'm a little bit confused.
Do I have to order a test and then wait for the result, then order the next one and so on? Because if I do something withouth seeing the result, it could be a penalty?
Yes you order more than one if appropriate, then do something else and move the clock to get results. What are you practicing on? You should be on USMLE world
Quote:
Also, once the window shows up saying that you only have 2 min left over, you can't change the location of the patient, right? How do I know then the time is up (there's no clock in the material as far as I can see)?
And, if I want a treatment to be for a specific number of days, I can't put that in, do I have to make an appointment for the patient in like say 7 days to stop his antibiotics?! Seems weird.
No days
no doses
just the therapy once or continuous till you D/C
at 2 min you must finish with orders/ D/c stuff and then exit with Diagnosis
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Old 08-21-2012
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Quote:
Originally Posted by dr_mhm View Post
So, when I'm practicing CCS cases I'm a little bit confused.
Do I have to order a test and then wait for the result, then order the next one and so on? Because if I do something withouth seeing the result, it could be a penalty?
Also, once the window shows up saying that you only have 2 min left over, you can't change the location of the patient, right? How do I know then the time is up (there's no clock in the material as far as I can see)?
And, if I want a treatment to be for a specific number of days, I can't put that in, do I have to make an appointment for the patient in like say 7 days to stop his antibiotics?! Seems weird.
If the case stable u ll able to order many tests, these preliminary tests help u to rule in or out the differential dx list. While subsquent test will be either to follow up or related to specific procedure.
In the real exam u ll be able to monitor ur last 2 min.
U r unable to specify the duration of treatment in CCS, just order continious
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Old 08-21-2012
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Also if in distress order stuff like O2 and ECG stat then do focused exam

all this is explained in UW CCS cases
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Old 08-21-2012
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Thanks guys. Some stuff is explained in UW, other things are not...
I get confused because if it's an office setting, you give antibiotics, then you see the patient again in say 2 weeks, do you have to d/c the antibiotic then? under orders you can't d/c anything (I mean, you're not going to d/c the antibiotic you want to give for say 7 days), you can only do that on the 2 min screen. Not sure if you know what I mean.
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Quote:
Originally Posted by dr_mhm View Post
Thanks guys. Some stuff is explained in UW, other things are not...
I get confused because if it's an office setting, you give antibiotics, then you see the patient again in say 2 weeks, do you have to d/c the antibiotic then? under orders you can't d/c anything (I mean, you're not going to d/c the antibiotic you want to give for say 7 days), you can only do that on the 2 min screen. Not sure if you know what I mean.
I think i got what u said, yes u may D/C the antibiotic in the 2 min. screen & continue with counseling.
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Quote:
Originally Posted by dr_mhm View Post
Thanks guys. Some stuff is explained in UW, other things are not...
I get confused because if it's an office setting, you give antibiotics, then you see the patient again in say 2 weeks, do you have to d/c the antibiotic then? under orders you can't d/c anything (I mean, you're not going to d/c the antibiotic you want to give for say 7 days), you can only do that on the 2 min screen. Not sure if you know what I mean.
Yes but you can send them to inpatient and to ER if needed too, I did one case where I sent them from office to ER for Temporal Artery biopsy then home then back to office in that order, no one does those biopsies in the office I know of.
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Old 08-22-2012
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Yes but you can send them to inpatient and to ER if needed too, I did one case where I sent them from office to ER for Temporal Artery biopsy then home then back to office in that order, no one does those biopsies in the office I know of.
Actually, if it's a normal procedure they wouldn't do it in the ER. E.g., you can order temporal artery biopsy, you just order it in the office, ask for the consent, and then "they" (meaning, the system) will do it, I would get a consult for surgery to do it but you don't need to change the patient's location. Ususally procedures are just done and you get the result (I mean in an office setting, except of course major surgery). E.g. if you order a routine ultrasound, you don't change the location either, you just order it in the office, even if you're not the one who's going to do it.
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Old 08-22-2012
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Quote:
Originally Posted by dr_mhm View Post
Actually, if it's a normal procedure they wouldn't do it in the ER. E.g., you can order temporal artery biopsy, you just order it in the office, ask for the consent, and then "they" (meaning, the system) will do it, I would get a consult for surgery to do it but you don't need to change the patient's location. Ususally procedures are just done and you get the result (I mean in an office setting, except of course major surgery). E.g. if you order a routine ultrasound, you don't change the location either, you just order it in the office, even if you're not the one who's going to do it.
Hmm I thought since Temporal Artritis was an emergency that it would go to the ER for steriods and biopsy stat?
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Old 08-22-2012
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Hmm I thought since Temporal Artritis was an emergency that it would go to the ER for steriods and biopsy stat?
It is a "treatment emergency", meaning, that you have to start prednisone ASAP to prevent complications (like blindness) but it's done in outpatient. As far as the temporal artery biopsy it's done as an outpatient procedure as well (results take a couple of days to come back anyway).
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Old 08-23-2012
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Default another question

so if I order a test in the office, and say, that test takes 4 days to come back, do I then sent the patient home and make an appointment in 4-5 days?
I see the results before that and the screen keeps asking me if I want to continue the clock or stop it - so continue and then see her on her app day?
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Old 08-23-2012
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Quote:
Originally Posted by dr_mhm View Post
so if I order a test in the office, and say, that test takes 4 days to come back, do I then sent the patient home and make an appointment in 4-5 days?
I see the results before that and the screen keeps asking me if I want to continue the clock or stop it - so continue and then see her on her app day?
Yes u r right, but keep in mind that moving the clock many times will direct u to 2 min. screen even if u r not done with the case. I read this notice during the exam, although they didnt mention how many times.
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  #13  
Old 08-23-2012
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Yes u r right, but keep in mind that moving the clock many times will direct u to 2 min. screen even if u r not done with the case. I read this notice during the exam, although they didnt mention how many times.
How's that? I mean, I want to see this guy in say 4 days but I can't move the clock to that day, it stops automatically whenever a result comes back so I HAVE to see it! I can't just see the guy in 4 days with all the results in hand
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Old 08-23-2012
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How's that? I mean, I want to see this guy in say 4 days but I can't move the clock to that day, it stops automatically whenever a result comes back so I HAVE to see it! I can't just see the guy in 4 days with all the results in hand
U r comment makes sense
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Old 11-19-2012
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Default Step 3 CCS cases time management help

Hi friends !!!

I am having a hard time managing time in CCS cases in Uworld. The 2 min screen appears too quickly. Does anyone know any tutorial that helps to learn how to manage time???
I will really appreciate all the help.:sorry:
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  #16  
Old 11-19-2012
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Please check this link
http://www.slideshare.net/usmlegalax...-workshop-2012
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