Pap Smear Technique

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
• Dont 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
• Dont use too much force (bleeding, pain)
• Dont 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)