The whole point of keeping stacks of Combat Support Cylinder up (beyond the 3% increase healing and damage) is to be able to pop Super Charged Gas. This is a great skill to use early in the fight when multiple mobs are on your tank. Why? Because when activated, Supercharge Gas + Kolto Missle will apply a 10% damage shield for 15 seconds to three targets. This may not seem like a lot but it helps reduce damage so you can manage your early fight heat. Once you pop that, immediately build up your stacks as soon as you can. By shooting your tank with Rapid Shots you build stacks and heal. Also, once you spec into it, your criticals from Rapid Shot will give you a 5 second Alacrity Boost from Chain Reaction skill.
Here is my "rotation":
1. Build stacks of Combat Support Cylinder pre fight with Rapid Shots.
2. Kolto Shell the Tank (once specced into it)
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3. Pop Super Charged Gas just after pull and Kolto Missle the melees. This gives 10% damage shield for 15 sec. Also, it will increase healing to the Tank by 5% for 15 seconds due to Kolto Residue.
4. Build stacks if everyone is ok, if not, use Healing Scan followed by Rapid Scan (note, this order is important becuase of the 16 Heat reduction of Rapid Scan from Healing Scan when specced into it). Rapid Scan will also build 6 stacks of Combat Support Cylider. Also, Healing Scan will apply a HOT and give +10% armor when specced into it (Proactive Medicine and Reactive Armor)
5. Rapid Shots always in between other heals. This gives your heat a couple of seconds to drop and heals the tank for a small amount and it builds stacks.
6. If you are taking damage, pop your own sheild and Healing Scan your self. Pop Chaff too if you have it
7. If your heat is too high becuase things went to hell, pop Vent Heat to drop your Heat down. Super Charged Gas will drop your heat 16 as well which can give you another Healing Scan in a pinch. Also, Supercharge Gas can be your "oh crap" button because it removes the cooldown on Healing Scan and increase healing and damage by 10% for 10 seconds. Be carefull with this becuase you can rapidly max your heat spamming Healing Scan. Vent Heat ASAP if this happens.
A few Key Points:
-Dont be afraid to CC something with Concussion Missle, its free if you spec into it and less active mobs = less healing for you.
-If you having nothing better to do Rapid Shots something to build stacks, either a party member or a mob.
-Heal early. Merc heals have a longer activation time. Dont get to far behind. They key is nice steady heals, even if it is not entirely needed. If we burst heal, we build heat to high.
-Supercharged Gas+Kolto Missle is your friend, 10% damage reduction is nothing to sneeze at. Also you get the 5% increase to healing on the target.