Reference Manual - IARC Screening Group

More documents

Recommendations

Info

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
Client Assessment and VIA Testingthe cervix and the diseased area on the record form (see Figure6-2).Step 6Step 7Discuss the results of the VIA test and pelvic examination withthe woman. If the VIA test is negative, tell her when to returnfor repeat VIA testing.If the VIA test is positive or cancer is suspected, tell the womanwhat the recommended next steps are. If treatment isimmediately available, discuss this possibility with her. Ifreferral is required for further testing or treatment, makearrangements for the referral and provide the woman with thenecessary forms and instructions before she leaves the clinic. Ifit is possible to make an appointment now, this is the best time.Note: Linking treatment to testing may vary among programs or clinicsand will be related to factors such as client flow, available resources,personnel and time. Several alternative schemes for arranging thiscritical linkage are outlined in Figure 6-4.Figure 6-4. Possible Links between VIA Testing and TreatmentAbnormal VIA(lesion < 75%, lesion < 2 mm beyond cryoprobe margin including tip ofprobe, no vaginal wall extension or extension into canal beyond reach ofOffer immediate treatment.Woman never leaves roombetween testing and treatment.She must receive all treatmentrelatedcounseling beforetesting takes place and musthave the chance to askquestions or reinforce thecounseling between testing andtreatment.Offer treatment afterfocused counseling.Woman leaves examinationarea and is counseled in aseparate room/area. Whencounseling is completed, shecan return to exam/treatmentarea for treatment.Offer treatment atseparate visit.Woman is given appointmentfor counseling and treatment onanother day or at anotherlocation. Appointment timeshould be specific. Providermust be able to contact womanin case appointment needs to bechanged or if woman does notappear for appointment.Cervical Cancer Prevention Guidelines for Low-Resource Settings 6-11
Page 1:
Cervical Cancer PreventionGuideline
Page 5:
TABLE OF CONTENTSPREFACE AND ACKNOW
Page 8:
How to High-Level Disinfect Surgica
Page 11 and 12:
Table C-2Figure C-1Preparing a Dilu
Page 13 and 14:
PREFACE AND ACKNOWLEDGMENTSThis ref
Page 15 and 16:
ONEINTRODUCTIONMAGNITUDE OF THE PRO
Page 17 and 18:
IntroductionFigure 1-3. Incidence o
Page 19 and 20:
Introductionprevalence areas, a sta
Page 21 and 22:
Table 1-2. Reduction in Cumulative
Page 23 and 24:
Introductiontheir performance was t
Page 25 and 26:
Introductionlesions, or a false pos
Page 27 and 28:
IntroductionCompared to other metho
Page 29 and 30:
Introductionsignificantly to women
Page 31 and 32:
IntroductionBelinson JL et al. 2001
Page 33 and 34:
IntroductionMitchell MF et al. 1998
Page 35 and 36:
IntroductionYlitalo N et al. 1999.
Page 37 and 38: TWOHUMAN PAPILLOMAVIRUS AND CERVICA
Page 39 and 40: Human Papillomavirus and Cervical C
Page 47 and 48: THREEPATHOPHYSIOLOGY OF CERVICAL CA
Page 49 and 50: With the onset of puberty, whichis
Page 51 and 52: Pathophysiology of Cervical Cancerp
Page 53 and 54: Pathophysiology of Cervical CancerP
Page 55 and 56: Pathophysiology of Cervical CancerI
Page 57 and 58: Pathophysiology of Cervical CancerR
Page 59 and 60: FOURTALKING WITH WOMEN ABOUTCERVICA
Page 61 and 62: Talking with Women About Cervical C
Page 69 and 70: FIVEPREVENTING INFECTIONS INHEALTHC
Page 71 and 72: Preventing Infections in Healthcare
Page 79 and 80: SIXCLIENT ASSESSMENT AND VIA TESTIN
Page 81 and 82: Client Assessment and VIA TestingFi
Page 83 and 84: Client Assessment and VIA TestingIN
Page 85 and 86: Client Assessment and VIA Testingst
Page 87: Client Assessment and VIA Testingsp
Page 91 and 92: SEVENTREATMENT AND FOLLOWUPBACKGROU
Page 93 and 94: Treatment and Followupregardless of
Page 95 and 96: Treatment and FollowupFigure 7-1. L
Page 97 and 98: Treatment and FollowupTable 7-6. Co
Page 99 and 100: Treatment and FollowupFigure 7-2 is
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
Page 107 and 108: Treatment and FollowupNote: When CO
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
Page 129 and 130: Infection Prevention Processeswith
Page 131 and 132: Infection Prevention ProcessesFigur
Page 133 and 134: Table C-4. Preparing and Using Chem
Page 135 and 136: Infection Prevention ProcessesStora
Page 137 and 138: Infection Prevention Processes• h
Page 139 and 140:
APPENDIX DTECHNICAL OVERVIEW OF THE
Page 141 and 142:
Technical Overview of the Cryothera
Page 143 and 144:
Figure D-5. Removing Protector Tube
Page 145 and 146:
Technical Overview of the Cryothera
Page 147 and 148:
Figure D-11. Gas Cylinder Secured t
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
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Figure G-18. Speculum in Place with
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
APPENDIX HPERCEIVED BARRIERS TO PRO
Page 207 and 208:
AVAILABILITY OF BASIC SUPPLIES AND
Page 209 and 210:
GLOSSARYAcetic AcidAcetowhite Chang
Page 211 and 212:
PatulousSquamocolumnarJunction (SCJ
Page 213 and 214:
ADDITIONAL READINGAlliance for Cerv
Page 216:
innovating to save liveswww.jhpiego
show all

Reference Manual - IARC Screening Group

Create successful ePaper yourself

Delete template?

Save as template?