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Pap Smear Technique

Pap Smear Technique. Positioning. Privacy Buttocks just off table Good Lighting Drape Standby. Padded Stirrups. Soft, padded stirrups Oven mitts Socks Battle dressings. Inspect. Spread labia Discharge Ulcers Growths. Anatomy. Vaginal Speculum. Warm Speculum. Warm water

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Pap Smear Technique

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  1. Pap Smear Technique

  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)

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