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The mud crab Scylla serratais lightly exploited along the East African seaboard. This study reports on fishing practices and gives preliminary estimates of abundance and size structures of the mud crab populations in Utende, Chole Island and Juani Island, Tanzania, and west of Quirimba and Ibo Island, Moçambique. Estimates for three mangrove habitats (in Tanzania); open channel (<1 per 25 m2), mangrove fringe (3 per 25 m2) and inner forest (1 per 25 m2) were obtained using burrow density and from burrow occupancy from fisheries data. Mud crabs from Tanzania were significantly smaller (carapace width) and less abundant (in terms of mass) than those from Moçambique. This newly exploited resource provides a potential alternative source of income, but local management and monitoring plans need to be implemented early.

IntroductionAcute upper GI bleeding (AUGIB) presents with a spectrum of severity. Current NICE guidance recommends risk-stratifying patients using the Glasgow-Blatchford score (GBS) and considering early discharge for patients with a pre-endoscopy Blatchford score of 01. STHK Teaching Hospitals has developed an ambulatory pathway to manage low-risk (GBS ≤2) patients with suspected AUGIB. Patients are commenced on the pathway by a Medical StR, then discharged home with a pre-arranged endoscopy (OGD) and a post-OGD medical review. Our aim was to assess the safety of this strategy.MethodData between May 2016 and Jan 2017 was retrospectively collected from e-case notes. A standard audit tool was used and included GBS, endoscopy findings, readmission, re-bleeding, transfusion, surgery and death. Local audit data was used to estimate total bed days saved.Results68 patients (M:F 34:34) were referred via the Low Risk GI Bleed Ambulatory Pathway. The mean age was 42, range 18–79. Median time to OGD was 1 day, range 0–10. 2 patients elected to defer their endoscopy by 10 days for non-clinical reasons. All patients were discharged after post-OGD medical review. 26 had a normal OGD, 6 had peptic ulcer disease.5 patients had a delay in the decision to ambulate, mean stay 1.2 days. 1 patient re-presented after 3 months with a suspected AUGIB, GBS was 1 and repeat OGD revealed oesophagitis. 6 patients were inappropriately referred and had GBS>2. No patients had stigmata of recent or active bleeding, none required endotherapy or surgery and no patients died. 1 patient recieved a blood transfusion.ConclusionOur data shows that patients with GBS ≤2 can potentially be managed safely with an ambulatory pathway and this supports previously published findings2,3. Using local audit data, median and mean length of stay for patients with GBS ≤2 is 2 and 3 days respectively. Between May 2016 and Jan 2017 we estimate to have saved 138–204 bed days. At an estimated cost of £400 per day, this equates to a saving of £55,200–81,6004.References. National Institute for Health and Care Excellence, June 2012. Acute upper gastrointestinal bleeding in over 16s: Management[CG141]. London: NICE.. Stewart RF, Murphy RFE, Church NI. “An ambulatory care protocol for managing low-risk patients with non-variceal upper GI bleeding”. Society of Acute Medicine Conference, Manchester, England, 30th Dec 2012.. Stanley AJ, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. The Lancet, vol 373, No. 9657, p42–47, 3rd Jan 2009.. https://data.gov.uk/data-request/nhs-hospital-stay. Department of Health. Data.gov.uk. NHS Hospital Stay, 24/08/2015.Accessed:17/02/17.Disclosure of InterestNone Declared

IntroductionSome patients who have stable cirrhosis require regular therapeutic paracentesis. In our hospital these patients would be admitted directly to the Gastroenterology ward for treatment. Given the pressure on inpatient beds we established a nurse led treatment unit on the Gastroenterology ward to avoid admissions and improve efficiency.MethodA ward administrative area was converted into a day unit containing two trolley beds. A paracentesis pathway including competency based training was developed and a band 6 specialist nurse position was established. Between May 2016 and December 2016 data was prospectively collected for all day case paracentesis procedures including demographics, length of stay, volume of ascites drained and complications. A retrospective review of electronic patient records was performed to calculate the length of stay (LoS) for those patients who had been previously admitted for elective paracentesis prior to the initiation of the nurse led service. National data for cost per bed day was used to estimate cost savings.ResultsFifty six day case paracentesis procedures were performed in the nurse led treatment unit between May 2016 and December 2016. Male:Female ratio was 54:2, mean age was 52 (range ). The mean volume drained was 9100mls (range 1,600–20 200,200mls). 54 (96%) of patient were discharged the same day following paracentesis. Two patients were admitted to the Gastroenterology ward, 1 patient was diagnosed with spontaneous bacterial peritonitis, 1 patient was found to have renal dysfunction. Mean LoS for patients admitted for elective therapeutic paracentesis was 4 days. We calculate that the nurse led treatment unit has saved 216 bed days. Assuming a cost of £400/bed day1this equates to a cost saving of £86 400 over a 9 month period.ConclusionA protocol driven, nurse led day case paracentesis service is safe, avoids hospital admissions, reduces demand on inpatient beds and saves money. This model of care is easy to establish, requires minimal investment and can have a significant impact in reducing bed days. We plan to expand the treatments offered in the nurse led treatment unit to support new ambulatory treatment pathways.Reference. Department of Health (2015). Data Requests: NHS Hospital Stay. Available at: https://data.gov.uk/data-request/nhs-hospital-stay. [Accessed 24th Feb 2017].Disclosure of InterestNone Declared