We are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy (www.esge.com) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (www.esgena.org) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.

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SUMMARYPlacement of an enteral stent is emerging as an effective alternative to surgery for symptomatic relief in patients with malignant gastric outflow and duodenal obstruction. We report experience in a series of patients who had the Wallstent enteral prosthesis inserted.21 consecutive patients with inoperable obstruction, median age 75 years, had twenty-three procedures for insertion of the Wallstent under fluoroscopic guidance. Stent implantation was successful in 18 patients (86%), all of whom gained relief from nausea and vomiting. There were no short-term complications. Median survival after the procedure was four months (longest ten months), and no deaths were related to insertion.The efficacy and lack of complications in this series support use of the endoscopically placed stent for palliative management of malignant upper gastrointestinal obstruction.

Introduction With issues of increasing demand for endoscopy procedures, there is a need to validate surveillance referrals. A nurse-led review of surveillance referrals was set up. The aim was to ensure that patients are seen at the right time based on current guidanceright patient, right time, right test. Methods A protocol was developed which outlined the process for nurses to review referrals for patients on planned surveillance waiting list for colonoscopy. All referrals were reviewed with the hospital notes; relevant information documented on the protocol form which included changes in health; medication etc. Referrals with no change followed the pathway of original planned care. Referrals which did not meet the guidance (coded by nurses as: no/unsure) were reviewed by consultant colorectal surgeons. After consultant review if there were changes to planned care both the patient and their GP's were informed by letter of the changes. Results A total of 296 surveillance referrals were reviewed between March -November 2012.Of these referrals were 126 were appropriate 170 were identified as needing changes to planned care. Of the 170 patients where changes were recommended, 115 were removed from the waiting list. 22 patients had a date change and 33 patients had no change to their planned care. Issues found for patients were: age, mental capacity, patient choice consideration, and documentation were: old versions or incomplete/illegible referrals, initial consultation documentation did not always include family history. See diagrams below: Conclusion Nurses are able to identify changes to planned surveillance colonoscopy referrals. Reducing risk to patients through inappropriate colonoscopy procedures; reducing waiting list and releasing capacity to other patients. This review shows there is a OC-077Introduction Endoscopy remains important diagnostic tools for evaluating disease, early detection of malignant lesions and the delivery of therapy within the gastrointestinal (GI) tract. There are a number of regimens that are utilised for the administration of intra-venous sedation, including benzodiazepines (BDZ). However, sedation for endoscopy is not without its risks with an influential report suggesting that many major complications arise from patients being over-sedated (1). Thus, factors that are utilised to reduce the amount of sedation, without a detrimental effect on intra-procedural comfort, are important. Thus the aim of our study was to assess the impact of a change in syringe size of BDZ offered to endoscopists on the amount of BDZ administered in sedated GI endoscopy. Methods A 2 centre, prospective trial comparing BDZ use across all forms of sedated endoscopy across two time periods. In the first period (1 st November 2010-31 st October 2011) endoscopists were given a single 5 ml syringe containing 5 mg midazolam. In the second time period (1 st November 2011-31 st October 2012) endoscopists were given two 2.5 ml syringes each containing 2.5 mg midazolam. BDZ use, comfort scores and complications wer...