Reference Manual - IARC Screening Group

Client Assessment and VIA TestingNote: The SCJ should be completely seen to determine if the cervix isnormal or abnormal.Step 11 As needed, reapply acetic acid or swab the cervix with a cleanswab to remove any mucus, blood or debris that developsduring the inspection and that may obscure the view. Disposeof used swab(s).Step 12 When visual inspection of the cervix has been completed, use afresh cotton swab to remove any remaining acetic acid from thecervix and vagina. Dispose of used swab(s).Step 13 Gently remove the speculum. If the VIA test is negative, placethe speculum in 0.5% chlorine solution for 10 minutes fordecontamination. If the VIA test is positive and, aftercounseling, the patient requests immediate treatment, place thespeculum on the high-level disinfected tray or container so itcan be used during cryotherapy.Step 14 Perform a bimanual examination and rectovaginal examination(if indicated). Check for cervical motion tenderness; size, shapeand position of the uterus; pregnancy or any uterineabnormality and enlargement or tenderness of adnexa.Post-VIA TasksStep 1Step 2Step 3Step 4Step 5Wipe the light source with 0.5% chlorine solution or alcohol toavoid cross-contamination between patients.Immerse both gloved hands in 0.5% chlorine solution. Removethe gloves by turning them inside out. If disposing of thegloves, place them in a leakproof container or plastic bag. If arectovaginal examination was performed, gloves must bedisposed of. If reusing surgical gloves, submerge them in 0.5%chlorine solution for 10 minutes for decontamination.Wash hands thoroughly with soap and water and dry them witha clean, dry cloth or air dry.If the VIA test is negative, ask the woman to move toward thehead of the table and help her sit up. Ask her to get dressed.Record the VIA test results and other findings such as evidenceof infection (cervicitis); ectropion; grossly apparent tumors; orNabothian cysts, ulcers or “strawberry cervix.” If acetowhitechange that is characteristic of a diseased cervix is present,record the cervical examination as abnormal. Draw a “map” of6-10 Cervical Cancer Prevention Guidelines for Low-Resource Settings