How do I install the Es Preop Bg Timing skill?

Run npx skillmds@latest add dromlakhani/es-preop-bg-timing in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es Preop Bg Timing safe to use?

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Which AI agents work with Es Preop Bg Timing?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es Preop Bg Timing free to use?

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Who published Es Preop Bg Timing?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es Preop Bg Timing by dromlakhani — Agent Skill

Name: Es Preop Bg Timing
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Preop Bg Timing

The clinician verifies that blood glucose concentrations are within the targeted range of 100 to 180 mg/dL during the 1 to 4 hours preceding surgery. A common trigger is the question, "Is the patient's BG in target range shortly before surgery?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Ensure preoperative blood glucose within target range 1-4 hours before surgery

STEP 1 — Gather Information

Collect the most recent point-of-care blood glucose (POC-BG) value, time of measurement relative to scheduled incision, diabetes status (type 1, type 2, none), current insulin regimen (basal, bolus, pump), recent carbohydrate intake, NPO status, and any recent hypo- or hyperglycemic episodes. Document the BG value and timestamp for decision-making.

STEP 2 — Rule In / Rule Out

Is the most recent POC-BG measurement within 100–180 mg/dL? If yes, proceed to Step 4 (clear for surgery). If no, go to Step 3.

STEP 3 — Classify or Stratify

Classify the deviation: hypoglycemia if BG <100 mg/dL; hyperglycemia if BG >180 mg/dL.

STEP 4 — Decide

For hypoglycemia, administer 15 g fast-acting carbohydrate, recheck BG in 15 minutes, and repeat until BG ≥100 mg/dL; for hyperglycemia, give correction insulin per institutional protocol, recheck BG in 30–60 minutes, and repeat until BG ≤180 mg/dL; if BG is within target, proceed to surgery.

Clinical Guardrails / Mimics / Pitfalls

Avoid delaying surgery for transient hyperglycemia if correction insulin can be given and surgery proceeds shortly after; prevent over-treatment causing hypoglycemia; do not give oral carbohydrates to NPO patients; consider recent insulin to avoid stacking; do not rely solely on sliding scale for persistent hyperglycemia; verify POC-BG device calibration; use scheduled basal insulin if patient uses basal at home.

Concrete Clinical Example

A 68-year-old with type 2 diabetes scheduled for hip replacement at 08:00 has a POC-BG of 92 mg/dL at 06:30 and feels shaky. Classified as hypoglycemia, receives 4 oz juice (15 g carbs). Recheck at 06:45 shows BG 108 mg/dL, within target, and surgery proceeds.

Source: Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

TODO: consider adding scripts/calc.py for the es-preop-bg-timing calculator

---name: es-preop-bg-timingdescription: The clinician verifies that blood glucose concentrations are within the targeted range of 100 to 180 mg/dL during the 1 to 4 hours preceding surgery. A common trigger is the question, "Is the patient's BG in target range shortly before surgery?"---# Ensure preoperative blood glucose within target range 1-4 hours before surgery## STEP 1 — Gather InformationCollect the most recent point-of-care blood glucose (POC-BG) value, time of measurement relative to scheduled incision, diabetes status (type 1, type 2, none), current insulin regimen (basal, bolus, pump), recent carbohydrate intake, NPO status, and any recent hypo- or hyperglycemic episodes. Document the BG value and timestamp for decision-making.## STEP 2 — Rule In / Rule OutIs the most recent POC-BG measurement within 100–180 mg/dL? If yes, proceed to Step 4 (clear for surgery). If no, go to Step 3.## STEP 3 — Classify or StratifyClassify the deviation: hypoglycemia if BG <100 mg/dL; hyperglycemia if BG >180 mg/dL.## STEP 4 — DecideFor hypoglycemia, administer 15 g fast-acting carbohydrate, recheck BG in 15 minutes, and repeat until BG ≥100 mg/dL; for hyperglycemia, give correction insulin per institutional protocol, recheck BG in 30–60 minutes, and repeat until BG ≤180 mg/dL; if BG is within target, proceed to surgery.## Clinical Guardrails / Mimics / PitfallsAvoid delaying surgery for transient hyperglycemia if correction insulin can be given and surgery proceeds shortly after; prevent over-treatment causing hypoglycemia; do not give oral carbohydrates to NPO patients; consider recent insulin to avoid stacking; do not rely solely on sliding scale for persistent hyperglycemia; verify POC-BG device calibration; use scheduled basal insulin if patient uses basal at home.## Concrete Clinical ExampleA 68-year-old with type 2 diabetes scheduled for hip replacement at 08:00 has a POC-BG of 92 mg/dL at 06:30 and feels shaky. Classified as hypoglycemia, receives 4 oz juice (15 g carbs). Recheck at 06:45 shows BG 108 mg/dL, within target, and surgery proceeds.**Source:** Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278> **TODO:** consider adding scripts/calc.py for the es-preop-bg-timing calculator

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