Pap Smear Technique

1. Pap Smear Technique Video

2. Positioning • Privacy • Buttocks just off table • Good Lighting • Drape • Standby

3. Padded Stirrups • Soft, padded stirrups • Oven mitts • Socks • Battle dressings

4. Inspect • Spread labia • Discharge • Ulcers • Growths

5. Anatomy

6. Vaginal Speculum

7. Warm Speculum • Warm water • Not too hot • Lubricates speculum • Don’t use K-Y, Surgilube or Vaseline to lubricate speculum

8. Insert Speculum • Spread labia • Keep labia apart • Blades remain closed until fully inserted

9. 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

10. Ayers Spatula • Concave end to fit the cervix • Convex end for vaginal wall and vaginal pool scrapings

11. Sample Cervix • Use concave end • Rotate 360 degrees • Don’t use too much force (bleeding, pain) • Don’t use too little force (inadequate sample)

12. Cytobrush • Insert ~ 2 cm (until brush is fully inside canal) • Rotate only 180 degrees (otherwise will cause bleeding)

13. Make Pap Smear • As thin as possible • Properly labeled

14. Spray with Fixative • Within 10-15 seconds • Allow to fully dry before packaging • Cytologic Fixative (hairspray works acceptably also)