Reference Manual - IARC Screening Group

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Technical Overview of the Cryotherapy Systemand supports proper functioning of the entire system. FCF will notinterfere with the proper freezing of cervical tissue. If, while performing a cryosurgical procedure using CO 2 , gasflow sputters/stops and the cryotherapy unit stops working, seeProblem 11 (Appendix E, page E-3).Figure D-7. Applying Freeze-Clear-Freeze TechniqueTo apply the FCF technique:• Use an electronic timer, a stopwatch, or a clock with a sweeping second hand to monitor the elapsed time, or havean assistant watch a clock and announce the timing at regular intervals.• The FCF technique should be applied from the start of the cryosurgical treatment procedure.– Begin applying cryotherapy by pressing the FREEZE (left) trigger.– After the first 15 seconds, (1) briefly press the DEFROST (right) trigger for only a second or less and thenrelease it and then (2) immediately press the FREEZE (left) trigger again to continue freezing.• Repeat this technique every 15 seconds during the entire 3 minutes of freezing. If possible, have an assistantmonitor the timing and announce “Clear!” every 15 seconds to signal the provider to use FCF. If the cryotherapy unit does become blocked and gas flow stops, follow the steps noted in Problems 8 or 9(Appendix E, page E-3) to melt the ice.Note: While using the FCF technique during a cryosurgical treatment procedure, white puffs of frost orsmall pieces of ice will blow out of the exhaust port on the bottom of the regulator. This indicates that theunit is clearing itself and preventing ice buildup.POST-PROCEDURE PROCESSINGAfter completing a cryosurgical treatment procedure, the provider and/orother health care worker, as appropriate, should perform the followingsteps to help ensure prevention of infection:• Put new examination or utility gloves on both hands.• Wipe the regulator, hose, and cryotherapy unit (the probe last) with acloth dampened with soapy water.• Unscrew the cryotip from the probe (Figure D-8), and place theprotector tube over the thin metal tube at the end of the probe (FigureD-9).• Put the cryotherapy unit in the holder on the regulator.• Separate the cryotip from the plastic sleeve, and insert the rubberstopper into the bottom of the cryotip shaft (Figure D-10).D-6 Cervical Cancer Prevention Guidelines for Low-Resource Settings
Technical Overview of the Cryotherapy SystemFigure D-8. Removing CryotipFigure D-9. Placing Protector Tube on ProbeFigure D-10. Removing Plastic Sleeve and Inserting Rubber Stopper• Wash the cryotip and plastic sleeve with soapy water until visiblyclean. Ensure that the rubber stopper does not fall out duringwashing.• Rinse the cryotip and plastic sleeve thoroughly with water. Allowthem to air-dry.• After cleaning and drying the cryotip and plastic sleeve, they shouldbe:• high-level disinfected by boiling or steaming, or by soaking inhigh-level disinfectant chemicals (e.g., 1% chlorine [made withboiled water] or 2–4% glutaraldehyde); or• sterilized with steam (autoclave), dry heat (dry heat oven), or gas(gas sterilizer).Cervical Cancer Prevention Guidelines for Low-Resource Settings D-7
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Cervical Cancer PreventionGuideline
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TABLE OF CONTENTSPREFACE AND ACKNOW
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How to High-Level Disinfect Surgica
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Table C-2Figure C-1Preparing a Dilu
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PREFACE AND ACKNOWLEDGMENTSThis ref
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ONEINTRODUCTIONMAGNITUDE OF THE PRO
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IntroductionFigure 1-3. Incidence o
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Introductionprevalence areas, a sta
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Table 1-2. Reduction in Cumulative
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Introductiontheir performance was t
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Introductionlesions, or a false pos
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IntroductionCompared to other metho
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Introductionsignificantly to women
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IntroductionBelinson JL et al. 2001
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IntroductionMitchell MF et al. 1998
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IntroductionYlitalo N et al. 1999.
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TWOHUMAN PAPILLOMAVIRUS AND CERVICA
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Human Papillomavirus and Cervical C
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THREEPATHOPHYSIOLOGY OF CERVICAL CA
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With the onset of puberty, whichis
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Pathophysiology of Cervical Cancerp
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Pathophysiology of Cervical CancerP
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Pathophysiology of Cervical CancerI
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Pathophysiology of Cervical CancerR
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FOURTALKING WITH WOMEN ABOUTCERVICA
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Talking with Women About Cervical C
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FIVEPREVENTING INFECTIONS INHEALTHC
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Preventing Infections in Healthcare
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SIXCLIENT ASSESSMENT AND VIA TESTIN
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Client Assessment and VIA TestingFi
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Client Assessment and VIA TestingIN
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Client Assessment and VIA Testingst
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Client Assessment and VIA Testingsp
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Client Assessment and VIA Testingth
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SEVENTREATMENT AND FOLLOWUPBACKGROU
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Page 95 and 96: Treatment and FollowupFigure 7-1. L
Page 97 and 98: Treatment and FollowupTable 7-6. Co
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Page 101 and 102: Treatment and Followup• Regulator
Page 103 and 104: Treatment and FollowupCRYOTHERAPY P
Page 105 and 106: Treatment and FollowupStep 6 Point
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Page 109 and 110: Treatment and FollowupStep 5Advise
Page 111 and 112: Treatment and FollowupBerget A, B A
Page 113 and 114: APPENDIX ATESTS FOR CERVICAL CANCER
Page 115 and 116: Tests for Cervical Cancer Screening
Page 121 and 122: APPENDIX BSCREENING TEST QUALITIES
Page 123 and 124: Screening Test Qualities and Their
Page 125 and 126: APPENDIX CINFECTION PREVENTION PROC
Page 127 and 128: Infection Prevention Processesfor m
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Page 131 and 132: Infection Prevention ProcessesFigur
Page 133 and 134: Table C-4. Preparing and Using Chem
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Page 139 and 140: APPENDIX DTECHNICAL OVERVIEW OF THE
Page 141 and 142: Technical Overview of the Cryothera
Page 143: Figure D-5. Removing Protector Tube
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Page 149 and 150: APPENDIX ETROUBLESHOOTING WITH THEC
Page 151 and 152: Table E-1. Following-Up on Commonly
Page 153 and 154: APPENDIX FPROCESSING SURGICAL GLOVE
Page 155 and 156: Processing Surgical GlovesTable F-1
Page 157 and 158: Processing Surgical GlovesSTEP 10:
Page 159 and 160: APPENDIX GPERFORMING BREAST AND PEL
Page 161 and 162: Performing Breast and Pelvic Examin
Page 163 and 164: Figure G-2. Breast Puckering or Dim
Page 165 and 166: Figure G-5. Checking for Nipple Dis
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Performing Breast and Pelvic Examin
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APPENDIX HPERCEIVED BARRIERS TO PRO
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AVAILABILITY OF BASIC SUPPLIES AND
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GLOSSARYAcetic AcidAcetowhite Chang
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PatulousSquamocolumnarJunction (SCJ
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ADDITIONAL READINGAlliance for Cerv
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Reference Manual - IARC Screening Group

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