本文へ移動
cccskills
無料GitHub で公開

endo-assess-backup-plan-injected-insulin

Evaluates the patient’s plan for using injected insulin in case of pump failure, including knowledge of basal-bolus dosing. Triggered by phrases such as 'Discuss sick-day plan for pump failure' or 'Review transition to injections if pump stops'.

dromlakhani/MD2SKILL
インストール方法を見る

含まれるファイル（1）

  • SKILL.md2.8 KB

SKILL.md（原文）

インストールする前に、エージェントに与えられる指示の中身を確認できます。

Assess back-up plan for injected insulin if pump fails

STEP 1 — Gather Information

Collect current pump settings (basal rates, bolus insulin-to-carbohydrate ratio, correction factor), total daily dose, carbohydrate counting proficiency, ability to operate pump and troubleshoot alarms, knowledge of sick-day rules, and availability of emergency supplies (syringes/pens, long-acting and rapid-acting insulin, glucose tablets, glucagon).

STEP 2 — Rule In / Rule Out

Does the patient have a documented back-up plan for injected insulin if the pump fails?

  • Yes → Proceed to assess plan adequacy.
  • No → Identify need to create a back-up plan.

STEP 3 — Classify or Stratify

Classify the back-up plan as adequate if it includes:

  • Correct basal insulin dose (e.g., long-acting analog equal to 24‑hour pump basal).
  • Appropriate bolus dosing (insulin-to-carbohydrate ratio and correction factor).
  • Carbohydrate counting ability.
  • Knowledge of hypoglycemia treatment and DKA prevention.
  • Access to injection supplies and emergency glucagon.
    Otherwise, classify as inadequate.

STEP 4 — Decide

If adequate: Reinforce the plan, review annually or with device changes, and ensure supplies are current.
If inadequate: Collaborate with the patient to develop a written back‑up plan, provide education on basal‑bolus conversion, carbohydrate counting, sick‑day management, and prescribe necessary injection supplies.

Clinical Guardrails / Mimics / Pitfalls

Do not assume the patient knows how to convert pump basal to basal insulin without calculation. Avoid giving vague instructions; provide specific doses and ratios. Do not overlook hypoglycemia treatment or DKA prevention in the plan. Never rely solely on memory; ensure the plan is written and accessible.

Concrete Clinical Example

A 28‑year‑old using a Medtronic 670G pump with basal 1.0 U/hr (total 24 U/day), bolus ratio 1:10 g carb, correction factor 1 U per 50 mg/dL >150 mg/dL. If pump fails, the back‑up plan is insulin glargine 24 U subcut daily at bedtime, insulin aspart 1 U per 10 g carbs plus correction per glucose, with glucose checks every 2‑4 hrs, ketone monitoring if glucose >250 mg/dL, and glucagon kit available.

Source: Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2016-2534

レビュー

まだレビューはありません。使ってみた感想をお寄せください。

ログインしてレビューを書く

同じリポジトリのスキル

概要と使いどころ

780g-pump-adjustment

無料

Guide pump setting adjustments for the MiniMed 780G system based on CareLink data, using Medtronic's 3-step follow-up workflow. Use when a clinician has CareLink data for a 780G patient and wants to know what to change — which setting, by how much, and how to program it. Triggers include: "what do I adjust", "how to fix high TIR", "how to reduce hypos", "adjust ICR/ISF/basal", "SmartGuard settings", "780G pump settings review", or any question about optimising 780G therapy after reviewing a download.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-acth-stim-test-interpretation

無料

Performs corticotropin stimulation test to diagnose adrenal insufficiency when morning cortisol is indeterminate (3-15 µg/dL). Triggers include morning cortisol 3-15 µg/dL requiring further AI testing.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-adrenal-crisis-treatment

無料

Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-aed-ai-education

無料

Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing AED such as phenytoin, carbamazepine, or oxcarbazepine.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-aed-lt4-monitoring

無料

In central hypothyroidism patients receiving levothyroxine who initiate enzyme‑inducing antiepileptic drugs, the guideline recommends checking free T4 at least 6 weeks after AED start and increasing the levothyroxine dose if free T4 falls below the target range. Triggers include: central hypothyroidism patient on levothyroxine starting antiepileptic drug such as phenytoin, carbamazepine, or oxcarbazepine.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-cortisol-cutoff-ai-diagnosis

無料

Applies serum cortisol cutoffs (<3 μg/dL indicates central adrenal insufficiency; >15 μg/dL likely excludes it) when evaluating morning cortisol for suspected adrenal insufficiency. Triggers include morning cortisol measurement in suspected AI and use when interpreting morning cortisol levels for adrenal insufficiency workup.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

dromlakhani のスキルをすべて見る

このスキルの問題を報告する