1. Swabs
Skill 304
Dr.
Mohammad Marie
Lecture \ 5

2. Learning objectives To recognize the procedure of throat swab.
To recognize the procedure of vaginal swab.
To recognize the procedure of cervical swab.

3. Procedure of Throat swab
1- With the patient’s head tilted back and the throat well illuminated, depress the tongue so that the back of the throat can be seen.

4. Procedure of Throat swab
2- Rub the swab up and down the back of the throat and against any white patches in the tonsillar area. Avoid the tongue and the cheeks.

5. Procedure of Throat swab
3- Replace the swab in the transport tube . 4- Seal tube tightly and label with patient’s information, and date . 5- Send the specimen to the laboratory .

6. Precautions
Gargling to clear the throat or treatment with antibiotics will affect culture results and may make identification of the bacteria impossible. The patient should not gargle immediately before the culture.

7. Culture of Throat swab Definition :
A throat culture is a microbiological procedure for identifying disease-causing bacterial organisms in material taken from the throat. A throat swab will capture the causative organism in most cases and the culture will allow the specific organism to be grown in the microbiology laboratory under certain conditions. The bacteria can then be identified .

8. Culture of Throat swab Purpose :
1- identify the specific bacterial organisms that are causing a sore throat or throat infection
2- a correct diagnosis is important to prevent unnecessary use of antibiotics for viruses that do not respond to them.
3- the bacteria identified are used to determine antibiotic sensitivity, allowing physicians to select the most appropriate and effective antibiotic to treat a specific infection.
It is common for physicians to order culture and sensitivity tests at the same time. ( c/s test )

9. Vaginal swab
Vaginal swabs are the specimens of choice when screening for :
1- trichomonas vaginalis

10. Vaginal swab
2- candida species
candida-albicans

11. Vaginal swab
3- gardnerella vaginalis with anaerobes .

12. Procedure of vaginal swab
1- Place the patient in dorsal position, supported by a pillow 2- ask her to bring her heels together, 3- bend her legs and then draw her heels towards her bottom. 4- Open the swab package

13. Procedure of vaginal swab
5- Remove the swab; do not touch the soft tip or lay the swab down. 6- Hold the swab as shown

14. Procedure of vaginal swab
7- Insert the swab into the lower part of the vagina (about two inches ). 8- Gently but firmly rotate the swab for 10 to 30 seconds in the vagina.
vagina

15. Procedure of vaginal swab
9- Withdraw the swab without touching the skin. 10- Place the swab into the test tube so that the tip of the swab is visible below the tube label Ensure that the swab is labeled accurately and place, with the completed request form 12- transport bag for transportation to the Department of Medical Microbiology.

16. Cervical swab
Also it is called : Papanicolaou test ,Pap smear, Pap test, cervical smear, or smear test .
A sample of cells from a woman's cervix (the end of the uterus that extends into the vagina ) is collected and spread (smeared) on a microscope slide. The cells are examined under a microscope in order to look for pre-malignant (before-cancer) or malignant (cancer) changes.
Changes can be treated, thus preventing cervical cancer, and cancer can be detected early.

17. Cervical swab
The best time for screening is between 10 and 20 days after the first day of menstrual period .
For about two days before testing, a woman should avoid douching or using spermicidal foams, creams, or jellies or vaginal medicines (except as directed by a physician). These agents may wash away or hide any abnormal cervical cells.

18. Procedure of cervical swab
1- Place the patient in dorsal position, supported by a pillow 2- ask her to bring her heels together, 3- bend her legs and then draw her heels towards her bottom.

19. Procedure of cervical swab
4- Moisten the speculum with warm water and insert into the vagina to separate the vaginal walls. Wipe away any excess cervical mucus with a tissue. Using a blue top Trans tube swab sample as high as possible into the vault. 5- Gently but firmly rotate the swab (a cervical brush)

20. Procedure of cervical swab
6- Withdraw the swab without touching the skin. 7- Remove speculum and wipe vaginal / vulval area with a tissue . 8- Place the swab into the test tube so that the tip of the swab is visible below the tube label . 9- Ensure that the swab is labeled accurately and place, with the completed request form 10- transport bag for transportation to the Department of Medical Microbiology.

22. Normal pap smear

23. Normal cervix

24. Abnormal pap smear

27. Thank you