Your Autopilot Protocol for the First Minute of Any Case
⚡ Key Strategy: This shows the scoring engine that you're a safe physician who stabilizes first, then works up the problem.
Critical Steps
6
Score Impact
High
Time Frame
60 Sec
Cases Covered
100%
Nasal cannula, mask, or intubation if severe distress/AMS
Secure adequate venous access
Continuous heart rhythm monitoring
Continuous oxygen saturation monitoring
Frequent monitoring based on stability
If hypotensive, dehydrated, septic
Any AMS, weakness, diaphoresis
Fluids, glucose, antibiotics
Acetaminophen, morphine/NSAID as appropriate
Unstable, chest pain, SOB, trauma, sepsis
Shock, respiratory failure, severe ACS, DKA with AMS
Stable but needs admission
Stable non-emergent
📌 Location change itself earns points
Infection, anemia, bleeding
Electrolytes, renal/liver status
UTI, sepsis workup
Chest pain, SOB, AMS, sepsis, arrhythmia risk
SOB, chest pain, fever, trauma
All women of childbearing potential
Before antibiotics
Do not delay if sepsis/meningitis
If source suspected
If surgery/procedure possible (abdominal pain, GI bleed)
If bleeding, trauma, or OR risk
Telemetry, neuro checks, I&O, daily weights if CHF/sepsis
Surgery (acute abdomen), OB (pregnancy complication), Psych (SI/HI), ID (sepsis)
As soon as the case opens: Fire off oxygen, IV, monitor, pulse ox, vitals, glucose.
Place the patient in the appropriate location (ER → ICU vs floor).
Order universal labs + imaging based on presentation.
Add cultures/antibiotics if febrile or signs of infection.
Advance time a few minutes → reassess vitals/labs.
💡 This is the single most powerful tool you can have for CCS. Think of it as your autopilot protocol: what to order in the first minute of any case before you even start tailoring to the scenario.