Pap Smear Technique

Video

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 1
 Positioning
Privacy
Buttocks just off table
Good Lighting
Drape
Standby

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 2
 Padded Stirrups
Soft, padded stirrups
Oven mitts
Socks
Battle dressings

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 3
 Inspect
Spread labia
Discharge
Ulcers
Growths

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 4
 Anatomy

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 5
Vaginal Speculum

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 6
 Warm Speculum
Warm water
Not too hot
Lubricates speculum
Dont use K-Y,
Surgilube or Vaseline to
lubricate speculum

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 7
 Insert Speculum
Spread labia
Keep labia apart
Blades remain closed
until fully inserted

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 8
Squamo-Columnar Junction
Junction of pink cervical skin
and red endocervical canal
Inherently unstable
Key portion of the cervix to
sample
Most likely site of dysplasia

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 9
 Ayers Spatula
Concave end to fit the
cervix
Convex end for vaginal
wall and vaginal pool
scrapings

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 10
 Sample Cervix
Use concave end
Rotate 360 degrees
Dont use too much force
(bleeding, pain)
Dont use too little force
(inadequate sample)

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 11
 Cytobrush
Insert ~ 2 cm (until brush
is fully inside canal)
Rotate only 180 degrees
(otherwise will cause
bleeding)

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 12
 Make Pap Smear
As thin as possible
Properly labeled

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 13
Spray with Fixative
Within 10-15 seconds
Allow to fully dry
before packaging
Cytologic Fixative
(hairspray works
acceptably also)

Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 14
Operational Obstetrics & Gynecology Bureau of Medicine and Surgery 2000 Slide 15