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
• Don’t 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
 Ayre 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
• Don’t use too much force
(bleeding, pain)
• Don’t 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