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- Smear(s) must represent an adequate number of cells, not too thick (cells obstructing cells) or too thin.
- Smear(s) must be well fixed immediately.
Supplies Needed:
Speculum, gloves, ayre spatula/endocervical brush, cotton swabs/gauze, labeled glass slide(s), slide carrier, fixative spray, cytology requisition form.
Procedure:
- Obtain supplies. A combination of spatula and endocervical brush are recommended.
- Insert the speculum. Cleanse surface of ectocervix with swab or gauze, removing excessive mucus, exudates, blood, or other debris that can obscure the collected cells.
- Introduce the spatula tongue into the cervical canal, so that it’s "shoulder" rests at the ectocervix.
- Rotate the spatula 360° using slight, but constant pressure so that it always remains in contact with ecto and endocervical mucosa.
- Spread cells along the long axis of the slide. If uneven, the same spatula may be used for quick re-spreading.
- Obtain an adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom most fibers are exposed. Slowly rotate ¼ or ½ turn in one direction.
DO NOT OVER-ROTATE. Note: For 1 slide technique, thinly spread cells collected from ectocervix, and endocervix over the same slide.
- Immediately fix the slide with fixative spray.
For Non-Pregnant Patients:
- Insert the endocervical brush into the endocervix until only the bristles closest to the handle are visible.
- Slowly rotate one half to one full turn. Remove.
- Prepare the smear by rolling the brush across the glass slide.
- Immediately spray fix the smear.
- Discard the brush and spatula.
- When fixative is dry, place slide in the slide carrier.
- Complete the cytology requisition including patient name and date of birth, physician’s name,
source of specimen (e.g. endo and ectocervix), LMP, clinical findings, pertinent patient history (e.g., surgery, hormonal status, etc.) and
previous pap results.
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