Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1 Pap Smear Technique Video
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1
Pap Smear Technique
Video
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 2
Positioning
• Privacy• Buttocks just off table• Good Lighting• Drape• Standby
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 3
Padded Stirrups
• Soft, padded stirrups• Oven mitts• Socks• Battle dressings
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 4
Inspect
• Spread labia• Discharge• Ulcers• Growths
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 5
Anatomy
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 6
Vaginal Speculum
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 7
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 8
Insert Speculum• Spread labia• Keep labia apart• Blades remain closed
until fully inserted
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 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
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 10
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 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)
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 12
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 13
Make Pap Smear• As thin as possible• Properly labeled
Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 14
Spray with Fixative• Within 10-15 seconds• Allow to fully dry
before packaging• Cytologic Fixative
(hairspray works acceptably also)