Conventional Pap SmearIndications:
Sampling of the superficial cells of the cervix, endocervix and/or vagina to detect premalignant and malignant lesions of the uterine cervix and other abnormalities of the reproductive tract.
Conventional pap Smear
1. Vaginal speculum
2. plastic spatula and cytobrush
3. clean glass slide (single end frosted)
4. black lead pencil
5. fixative (spray fixative or 95% ethyl alcohol)
6. CPA gynecologic cytology requisition form
7. Slide container for transport
8. Biohazard bag for specimen transport with a biohazard label
In premenopausal patients, obtain specimen during second half of menstrual cycle (if possible) to avoid obscuring blood. Instruct the patient not to douche or engage in sexual intercource within 24 hours of the procedure.
1. Print the patient's name (last, first) on the frosted end of the glass slide with
a black pencil before beginning the procedure. The laboratory CANNOT accept
2. Place the patient in the lithotomy position. Using a speculum lubricated with
warm water, expose the cervix as fully as possible. DO NOT use lubricant as
this will interfere with the cytologic evaluation.
3. If excess mucus, exudate or blood is present at the cervical os, remove with
a folded gauze pad or large cotton-tipped swab. Obtain a sample of the
ectocervix and transition zone (if visible) by rotating the plastic spatula 360
degrees around the cervical os. Hand the spatula with the collected specimen
to an assistant so that the cytobrush can be used to sample the endocervical
canal. Rotate the cytobrush one half turn and hand to the assistant.
4. Quickly smear the material from the spatula on one end of the pre-labeled
glass slide and then rotate the cytobrush to deposit material on the other half
of the glass slide. Immediately immerse the slide in fixative (95% ethyl alcohol)
or use spray fixative. If using spray fixative, hold the container approximately
12 inches from the slide to avoid “spray” artifacts that can interfere with
5. If using spray fixative, allow the slide to dry completely before placing the
slide in the dry slide container for transport to the laboratory. If using wet
fixative (95% ethyl alcohol), secure the lid to the plastic container and send
the specimen, in the fixative, to the laboratory.
6. Use the specimen collection biohazard bags provided by CPA. Place the
completed requisition in the outside pocket and the properly labeled slide
(in its container) in the zip lock portion of the bag. Send to CPA
Submit all patient information following the procedure for "Completing a Gynecologic Cytology Requisition".
Complete test requisition including last and first name of patient, patient's date of birth and social security number, body site and source of specimen collected. Label specimen container (using the labels provided on the requisition) with patient's first name and last name, and body site/source. The container must have at least two (2) unique identifiers. Examples of unique identifiers: patient name, DOB, unique bar code, etc. Include pertinent clinical information, i.e., previous malignancy, radiation therapy, drugs, etc. Place container in a specimen bag with a biohazard label. Place the requisition in the side pocket of the specimen bag.
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