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Conventional Pap-Routine

Supplies: Vaginal speculum, plastic extended-tip spatula, cytobrush and fixative (spray fixative or bottle of 95% ethanol), clean glass slide (single end frosted), black lead pencil and test request form. Pap kits are available from PLA.

Collection procedures:
a) Label one (1) slide with patient’s first and last name and specimen source.
b) Use an un-lubricated speculum (saline or warm water may be used).
c) After visualization of the cervix is accomplished insert the spatula into the cervix. Rotate the spatula 360 degrees to perform a scraping. This will allow a specimen to be obtained from the transformation zone where neoplasia occurs. In post menopausal patients, it is desirable to obtain a sample from the vaginal pool (posterior fornix) with the rounded end of the spatula.
d) Make a smear lengthwise along one side of a previously labeled glass slide. Smear slide thinly and evenly.
e) If a cytobrush is used, insert the cervical brush into the cervical os with gentle pressure and rotate only 90 to 180 degrees to minimize bleeding.
f) Quickly make an adjacent lengthwise smear on the same slide spreading material quickly and evenly. The endocervical mucus will prevent air-drying during collection of the subsequent cervical component.
g) “Broom”, another collection instrument for taking Pap smears, is a plastic “broom-like” brush which simultaneously samples the endocervix and ectocervix at the same time. To use the broom insert the long central bristles into the cervical os until the lateral bristles bend against the ectocervix and rotate in a clockwise direction 360° in the same direction five (5) times while maintaining gentle pressure. The broom is removed and with a single paint stroke motion the cellular sample is transferred down the long axis of the labeled slide surface. The broom is turned over the paint stroke motion is repeated over the same area.
h) Fix immediately (spray with fixative holding the spray bottle approximately 10-12 inches from the slide or drop slide into 95% ethanol fixative).
i) Complete the Cytology test request form, including relevant clinical information. Submit the specimen to the Cytopathology Laboratory.

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