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Suppose that in one of your CCS cases during the exam, your patient is in the inpatient unit and you're giving them the appropriate treatment and advance the clock. Then all of a sudden, the case ends which takes you to the two minute section where you write your orders. In this case are you assuming that the patient will remain in the hospital or will be discharged?

The reason I asked is that I just did Case 4 (ectopic pregnancy). After giving methotrexate and advancing the clock, the case suddenly takes me to the 2 minute section. However, I'm not sure whether the patient will stay in hospital or go home. So I'm not sure whether to change IV meds to PO or even counsel about no smoking, no alcohol, etc. if the patient is not going home.

Anybody have any suggestions?

From what i understand, when the case ends its not necessarily the end of the treatment of the patient.
so they can still be in-patients when you finish the times allocation.
At the same time some cases like the constipation one or foreign body inhalation are meant to finish in the given time allocation.

Ok so if that's the case, how do we go about writing final orders? Do we still change IV meds to PO, or do counselling about smoking, alcohol, etc?

I wouldn't change the medications because we don't know if the patient is responding or stabilized. I would counsel and order future tests if needed like a pap smear if she is due later on.

Look at the simulated time and patients' status before you decide to disconnect their IV lines and meds...

even though you manage a MI case in few hours of simulated time, you don't start sending them home,, you keep them at the hospital for observations for couple days before discharge....so if you are on the 2 min screen and only 5-6 hours elapsed since pt got to ER, you don't disconnect their IVs...you keep them on..

Now if you have a pt who is all better and has been stable for 24 hrs and you are on 2 min screen, you can send them home by changing IV meds to oral etc..

So in a way you have to be the best judge of it depending on the case...

Keep in mind that you cannot send the patient home on the 2 min screen hence why I wouldn't stop any meds or treatment.

Yeah i agree.
I only stop an IV or NPO when the patient says they are better and bowels opened and suddenly the 2 min window comes up.