PWE-046 Most referrals for gastroscopy (ugie) in freetown, sierra leone (sl) have benign disease though in some, there was a need to disprove recently diagnosed malignancy – preliminary results from freetown ugie training project

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Abstract

Introduction

Endoscopy services are rudimentary in SL with no formally accredited endoscopists and a single Olympus stack and gastroscope.

Introduction

Supported by a grant from the British Society Of Gastroenterology (BSG) we delivered a training program in UGIE to 4 postgraduate doctors and 3 nursing assistants (7 trainees). We aim to develop a comprehensive database over the next 12 months and here give the findings in the initial cases.

Method

4 UK accredited trainers; DN, JH, CM and CW visited SL in 11/2016 and delivered a 3 day course for the 7 trainees. Whole team were taught essentials of scope handling and disinfection, patient safety monitoring and basic life support. The nurses were taught to support patient head and reassure the patient, monitor vital signs and give reports to the endoscopist. Trainee doctors were supported in performing 3 UGIE each during the course and taught to observe and give feedback to each other using the UK Direct Observation of procedural skills (DOPS) forms. They performed subsequent procedures together; 1 performing the UGIE, 1 acting as supervisor and 1 recording a video. Videos were sent to trainers in UK with patient consent, findings confirmed and feedback given. Reports recorded on ADAM database (Fujifilm), which was analysed for this report, together with the videos.

Results

There have been a total of 31 procedures performed, 14 on the course rest by 3 of the 4 trainees, working together as described. Clinical data reported in Table 1

Conclusion

We have developed a system of effectively monitoring performance of safe UGIE remotely with local colleague support, helping with patient management.

Conclusion

Similar to other areas of the world, majority of patients with dyspepsia without alarm symptoms have been shown to have benign pathology or normal UGIE.

Conclusion

Also, importantly, we downgraded the previous misdiagnosis of cancer in two males in their 40s.

Conclusion

We feel that these findings support the BSG assisted project to develop UGIE services as a helpful development in Sierra Leone

Disclosure of Interest

None Declared

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