Reference Manual - IARC Screening Group

Treatment and FollowupNote: During the cryotherapy procedure, the cylinder will become cold,and moisture may form on the outside of the cylinder and hose. Inaddition, the pressure gauge will show a drop in pressure. All of thesechanges are normal. If the pressure gauge, however, shows that thepressure is below 50 kg/cm 2 , stop performing cryotherapy. Wait untilthe cylinder returns to room temperature and the gas pressure risesabove 50 kg/cm 2 . Also, white grains of ice may come out of the exhaustport. This is normal and will not interfere with the operation of thecryotherapy unit.Step 13 At the end of the procedure inspect the cervix carefully toinsure that a hard, white, completely frozen “iceball” is present.If not, repeat steps 9–11 at least once putting more pressure onthe cervix. Ensure that adequate pressure is displayed on thegauge attached to the cryotherapy unit. If pressure isinadequate, arrange for gas resupply and reschedule theprocedure.Step 14 After the procedure, close the master cylinder valve.Step 15 Inspect the cervix for any bleeding. If there is bleeding, applypressure to the area using a clean cotton swab. Dispose ofswab(s).Step 16 Remove the speculum and place in a 0.5% chlorine solution for10 minutes for decontamination.Postcryotherapy TasksStep 1Step 2Step 3Step 4Wipe the light source with 0.5% chlorine solution or alcohol toavoid cross-contamination between patients.Immerse both gloved hands in 0.5% chlorine solution. Removegloves by turning inside out. If disposing of gloves, place inleakproof container or plastic bag. If reusing surgical gloves,submerge in 0.5% chlorine solution for 10 minutes fordecontamination.Wash hands thoroughly with soap and water and dry with clean,dry cloth or air dry.Check that the woman is not having excessive cramping beforeshe sits up, gets off the examining table and gets dressed. Ifsevere cramping persists beyond 5–10 minutes, give her an oralanalgesic (acetaminophen or ibuprofen).7-18 Cervical Cancer Prevention Guidelines for Low-Resource Settings