CCS case time constraints overview

Time Constraints Overview - The Ticking Clock

• Total Allotment: Each CCS case runs for a maximum of 8 minutes of real time.
• Simulated Clock: In-game time advances based on the orders you give and results you await. A simple action might take minutes; a complex test could take hours of simulated time.
• The 2-Minute Warning: A pop-up appears when 2 minutes of real time remain. This is your critical cue to finalize management, as the case will end shortly.
• Case Conclusion: The simulation ends when you manually choose "End Case" or when the 8-minute timer expires. Inefficient management can cause you to run out of time before reaching a diagnosis or definitive treatment.

⭐ After the 2-minute warning, only place essential, life-saving, or final diagnostic/treatment orders. Avoid routine tests that won't return in time.

The 2-Minute Warning - Endgame Strategy

Final 2 minutes: Shift from investigation to conclusion. Your goal is to demonstrate decisive, safe case closure. Avoid letting the timer end the case for you.

• Review & Finalize: Quickly scan active orders, patient status, and vitals. Ensure stability.
• Concluding Orders: Add essential final steps like "Counsel patient," "Advise follow-up," or health maintenance tasks.
• Proactive Finish: Once confident, use the "Advance clock" option to end the encounter.

⭐ Actively ending the case yourself signals completion and confidence. Letting time expire can imply you were indecisive or forgot the final diagnosis.

Pacing & Efficiency - Beat the Buzzer

• The Golden Minutes (First 2-3 min):

  • Rapidly assess vitals & chief complaint.
  • Perform a focused physical exam (e.g., chest pain → heart & lung sounds).
  • Order critical initial labs & imaging immediately. Think STAT orders: CBC, CMP, Troponin, ECG, Portable CXR.

• Mastering the Clock:

  • Early phase: Use small time jumps (2-5 min) to check initial results.
  • Stable phase: Once stable, advance in larger chunks (10-30 min) or use "until next result."
  • Avoid analysis paralysis. If stuck, advance time to see how the patient responds or if new data arrives.

• Efficient Workflow:

  • Batch your orders. Order all necessary labs or imaging at once before advancing the clock.
  • Move the patient to the appropriate location (e.g., Floor, ICU) as soon as indicated.
  • Perform counseling (e.g., smoking cessation, diet) while awaiting non-urgent test results.

• 📌 Mnemonic: "PACE"

  • Physical Exam (Focused)
  • Advance Clock (Strategically)
  • Critical Orders (First)
  • Evaluate Results (Actively)

⭐ The single most common error is failing to advance the clock. The simulation penalizes inaction. If you've placed orders, you must move time forward to get results and see their effect.

High‑Yield Points - ⚡ Biggest Takeaways

• Most CCS cases have a 10-minute real-time limit, with a crucial 2-minute warning notification.
• You must manually advance the clock; the simulation does not move forward automatically.
• Failure to input a final diagnosis and essential end-of-case orders before time runs out leads to a heavy score penalty.
• Effective clock management is a core skill; allocate time wisely between history, exam, orders, and re-evaluation.
• The case concludes abruptly at the time limit, locking your final inputs.