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Cervical screening test (Pap smear)

Checklist
I. Communication with patient Done Not Done

 Introduces self, name, role, and purpose of the procedure.


 Wash your hands.
 Ask if the Patient is pregnant.
 Assess the patient’s understanding.
 Explain the procedure.
 Explain the need of a chaperone.
 Gain consent.

II. Gathering Equipment

 Gloves
 Lubricant
 Speculum
 A light source
 Endocervical brush
 Sample pot

III. Position

 The patient should be positioned supine on a bed with their underwear removed and their
abdomen exposed.
 Position the patient in the modified lithotomy position (heels towards the bottom and knees
falling aside).

IV. Inspection

 Wear the gloves


 Inspecting the vulva for
 Ulcers
 Abnormal vaginal discharge
 Scars from previous surgeries
 Vaginal atrophy
 Masses
 Erythema
 Bleeding
 Varicosities
V. V. Cervical screening test

 Inserting the speculum


1. Lubricate the speculum.
2. Warn the patient that you are about to insert the speculum.
3. Use your left hand (index finger and thumb) to separate the labia.
4. After making sure that the speculum is closed, insert the speculum gently sideways.
5. After inserting, rotate the speculum back to 90 degrees (handle facing upwards).
6. Start opening the blades of the speculum until the cervix is visible.
7. Tighten the locking nut to fix the position of the blades.

 Inspect the cervix


 External Os (open or closed)
 Cervical erosions
 Masses
 Ulcers
 Abnormal discharges

 Obtaining the sample


1. Insert the Endocervical brush through the speculum into the Endocervical canal
2. Rotate the brush 5 times, 360 degrees, in a clockwise direction.
3. Remove the brush avoiding touching the speculum.
4. Deposit the tip of the brush into the liquid based sample pot.

 Removing the speculum


1. Loosen the locking nut, then partially close the blades.
2. Rotate the speculum 90 degrees back to its insertion position.
3. Gently remove the speculum.
4. Cover the patient.
5. Dispose of the speculum and gloves.
6. Wash your hands.

VI. Completion

 Thank the patient.


 Offer to help get dressed and cover up.
 Label the sample.
 Summarize your findings.

HDRC
January 2019