How do I install the Es Pump Hybrid Continuation skill?

Run npx skillmds@latest add dromlakhani/es-pump-hybrid-continuation 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 Pump Hybrid Continuation safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es Pump Hybrid Continuation?

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 Pump Hybrid Continuation free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Es Pump Hybrid Continuation?

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

Es Pump Hybrid Continuation by dromlakhani

Name: Es Pump Hybrid Continuation
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Pump Hybrid Continuation

This skill determines whether a patient using a hybrid closed-loop insulin pump can continue this therapy upon hospital admission. It is triggered by questions such as "Can hybrid closed-loop pump be continued given hospital constraints?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Assess feasibility of continuing hybrid closed-loop insulin pump at admission

STEP 1 — Gather Information

Collect data on pump type (hybrid closed-loop), baseline settings, CGM status, anticipated hospital LOS, contraindications (impaired consciousness, inability to adjust pump, critical illness, DKA, HHS), hospital resources (expertise in insulin pump therapy, policies, supplies), and potential interference (MRI/CT, vasoactive meds, skin infection/hypoperfusion, acetaminophen >4 g/day, dopamine, vitamin C, hydroxyurea). Flag any absolute contraindications to pump use.

STEP 2 — Rule In / Rule Out

Determine if continuation is feasible: (hospital has expertise in insulin pump therapy) OR (anticipated LOS ≤1‑2 days). If YES, proceed to assess pump/CGM function; if NO, transition to scheduled subcutaneous basal bolus insulin (BBI) therapy.

STEP 3 — Classify or Stratify

Assess whether CGM and pump can function without hospital interference. If YES, continue hybrid closed-loop with CGM guidance. If NO (interference expected or CGM likely to fail), evaluate if pump can be used in manual mode (patient able to adjust settings, supplies available, no contraindications). If manual mode feasible, plan for manual pump use; if not, transition to SC BBI.

STEP 4 — Decide

If CGM/pump functional without interference: continue hybrid closed-loop therapy with CGM-guided adjustments. If CGM/pump not functional but manual mode feasible: continue insulin pump in manual mode with patient self-management and POC‑BG confirmation. If neither feasible: transition to scheduled subcutaneous basal bolus insulin (BBI) therapy.

Clinical Guardrails / Mimics / Pitfalls

Do not continue pump if patient has impaired consciousness, inability to adjust pump settings, critical illness (ICU), DKA, HHS, or if hospital lacks expertise and anticipated LOS >1‑2 days without a transition plan. Avoid interference from MRI/CT, vasoactive pressors, acetaminophen >4 g/day, dopamine, vitamin C, hydroxyurea. Do not assume pump will work without verifying supplies, patient consent, and ability to self‑manage.

Concrete Clinical Example

A 58‑year‑old patient with type 1 diabetes using a hybrid closed‑loop pump is admitted for elective surgery. Hospital has pump expertise, anticipated LOS 2 days, no contraindications, no expected interference. Continue hybrid closed‑loop pump with CGM guidance.

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

---name: es-pump-hybrid-continuationdescription: This skill determines whether a patient using a hybrid closed-loop insulin pump can continue this therapy upon hospital admission. It is triggered by questions such as "Can hybrid closed-loop pump be continued given hospital constraints?"---# Assess feasibility of continuing hybrid closed-loop insulin pump at admission## STEP 1 — Gather InformationCollect data on pump type (hybrid closed-loop), baseline settings, CGM status, anticipated hospital LOS, contraindications (impaired consciousness, inability to adjust pump, critical illness, DKA, HHS), hospital resources (expertise in insulin pump therapy, policies, supplies), and potential interference (MRI/CT, vasoactive meds, skin infection/hypoperfusion, acetaminophen >4 g/day, dopamine, vitamin C, hydroxyurea). Flag any absolute contraindications to pump use.## STEP 2 — Rule In / Rule OutDetermine if continuation is feasible: (hospital has expertise in insulin pump therapy) OR (anticipated LOS ≤1‑2 days). If YES, proceed to assess pump/CGM function; if NO, transition to scheduled subcutaneous basal bolus insulin (BBI) therapy.## STEP 3 — Classify or StratifyAssess whether CGM and pump can function without hospital interference. If YES, continue hybrid closed-loop with CGM guidance. If NO (interference expected or CGM likely to fail), evaluate if pump can be used in manual mode (patient able to adjust settings, supplies available, no contraindications). If manual mode feasible, plan for manual pump use; if not, transition to SC BBI.## STEP 4 — DecideIf CGM/pump functional without interference: continue hybrid closed-loop therapy with CGM-guided adjustments. If CGM/pump not functional but manual mode feasible: continue insulin pump in manual mode with patient self-management and POC‑BG confirmation. If neither feasible: transition to scheduled subcutaneous basal bolus insulin (BBI) therapy.## Clinical Guardrails / Mimics / PitfallsDo not continue pump if patient has impaired consciousness, inability to adjust pump settings, critical illness (ICU), DKA, HHS, or if hospital lacks expertise and anticipated LOS >1‑2 days without a transition plan. Avoid interference from MRI/CT, vasoactive pressors, acetaminophen >4 g/day, dopamine, vitamin C, hydroxyurea. Do not assume pump will work without verifying supplies, patient consent, and ability to self‑manage.## Concrete Clinical ExampleA 58‑year‑old patient with type 1 diabetes using a hybrid closed‑loop pump is admitted for elective surgery. Hospital has pump expertise, anticipated LOS 2 days, no contraindications, no expected interference. Continue hybrid closed‑loop pump with CGM guidance.**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

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