Cervical Smears

Question 1

What general equipment do you need for performing cervical smears?

Answer 1

Angle poise lamp, trolley, gloves, speculum, request form, couch

Question 2

What do you need for a cervical smear?

Answer 2

Cervical broom, cytology solution bottle

Question 3

What do you need for a high vaginal swab?

Answer 3

Labelled sterile swab and culture medium container

Question 4

What should be included in your introduction?

Answer 4

Introduce, check patient details, explain procedure, gain consent
Ask if bladder is empty
Menstrual history
Discharge/abnormal bleeding, any concerns
Chaperone
Write number and name on bottle

Question 5

How should the patient be positioned?

Answer 5

Lying in supine, knees and hips flexed and ankles close together

Question 6

How do you insert the speculum?

Answer 6

Lubricate speculum
Introduce 90 degrees to opening position
Insert and gently rotate then open blades

Question 7

What do you examine the cervix for?

Answer 7

Note appearance, discharge, bleeding, polyps/ulcers/cancers

Question 8

How do you perform liquid based cytology in a pap smear?

Answer 8

Insert the broom into the os so the small bristles touch the cervix
Rotate 5 times
Push broom into the bottom of the jar x10, vigorously stir
Tighten cap so line on the cap is past line on the vial
Record patient DoB and name on vial

Question 9

When should a high vaginal swab be performed and what should it be tested for?

Answer 9

When: if STI suspected, discharge, irritation/soreness of vagina/vulva
MC&S, candida, trich, gram film for BV, pH

Question 10

How do you perform a high vaginal swab?

Answer 10

Open the swab but leave in the packet
Take swab from the posterior fornix or where there is discharge present
Place swab into the medium container

Question 11

How do you withdraw the speculum?

Answer 11

Withdraw slightly before closing to avoid catching the cervix