Reference Manual - IARC Screening Group

Treatment and Followupthe slots beneath the nipple of the cryotip and firmly securethem in position.Step 4Remove the protective cover from the end of the probe.Step 5 Before bringing the patient into the examination/procedurearea, be sure she has emptied her bladder if it has been morethan 30 minutes since the VIA test. Ask her to undress onlyfrom the waist down. Following this, help her onto theexamining table and drape her for the procedure.Step 6Step 7Wash hands thoroughly with soap and water and dry with aclean, dry cloth or air dry. Then, put one pair of newexamination or high-level disinfected surgical gloves on bothhands. 8Arrange the instruments and supplies on a high-leveldisinfected tray or container, if not already done.Cryotherapy ProcedureStep 1Step 2Step 3Step 4Step 5Tell the woman that the speculum is about to be inserted andthat she may feel some pressure.Gently insert the speculum fully or until resistance is felt andslowly open the blades to see the cervix. Adjust the speculumso that the entire cervix can be seen. This may be difficult incases where the cervix is large, parous, patulous or extremelyanterior or posterior. It may be necessary to use a clean cottonswab, spatula or forceps to gently push the cervix down or upinto view.When the cervix can be seen in its entirety, fix the blades of thespeculum in the open position so that it will remain in placewith the cervix in view. This enables the provider to have atleast one hand free.Move the light source so that you can see the cervix clearly.Use a cotton swab to remove any discharge, blood or mucusfrom the cervix. Identify the cervical os, the SCJ, and the siteand size of the lesion. If necessary, apply acetic acid so that thelesion can be seen. Dispose of the swab by placing in aleakproof container or plastic bag.8 If additional gloves are available, put a second glove on one hand so that when you are ready to use the light source,you can remove the outer glove and move the light source with a clean glove.7-14 Cervical Cancer Prevention Guidelines for Low-Resource Settings