Dr. Flowers: Hello, Mr. Castro. How are you feeling today?

Mr. Castro: Estoy bien. Gracias por preguntar, doctor. Estoy un poco preocupado por mi
hijo. Dice que las inyecciones de medicamentos le molestan mucho y como ha estado
enfermo durante mucho tiempo, no sé si hay algo que podamos hacer.

Dr. Flowers: That’s actually the reason why I’m here today. We think that your child may
benefit from having a PICC line placed in his arm, so it would be more comfortable for him
to receive medicine that way and avoid all the poking.

Mr. Castro: No lo entiendo muy bien. ¿Qué tipo de catéter es ese? ¿PICC?

Dr. Flowers: PICC is an acronym for ‘’Peripherally Inserted Central Catheter’’. This is a
thin,bflexible tube placed in a large vein in the forearm that carries blood into his heart to
administer medicine directly into his bloodstream with no need to use needle sticks
repeatedly.

Mr. Castro: Oh, eso suena bien. Pero, ¿no le va a hacer daño a mi hijo cuando le ponga
eso?

Dr. Flowers: There may be slight discomfort during the procedure, but it does not hurt. The
PICC insertion site will be numbed with local anesthesia.

Dr. Flowers: We will use ultrasound images to gently insert a needle first, then a guide wire
and a catheter, into a large vein near the heart.

Dr. Flowers: We will widen the puncture site a little with a scalpel.

Dr. Flowers: Once we have the PICC line placed in the right spot near the heart, we will
suture it to the skin with one or two stitches to prevent its accidental removal or movement.

Dr. Flowers: After that, every time we give your son medicine, it’s going to be through that
catheter. He will feel much more comfortable. We will keep the PICC site covered with a
dressing to protect the area.

Mr. Castro: Muy bien. Así a mi pequeño no le dolerá el brazo de sacarle tanta sangre. No
quiero que le pinchen por todas partes. ¿Ese procedimiento tiene algún riesgo?

Dr. Flowers: There are some risks associated with this procedure as with most medical
procedures, though they rarely occur. There can be bleeding at the insertion site.
Dr. Flowers: An artery, nerve, or tendon may be accidentally punctured at the time of the
insertion of the PICC line.
Dr. Flowers: The risk of blood clot formation around the catheter in the vein and infection
around the insertion site may occur. This can cause swelling and pain.

Dr. Flowers: If the PICC line is rubbing or moving too close to the heart, it may cause
abnormal heart rhythm and damage to heart muscles.

Mr. Castro: Vaya, todo eso suena muy mal, doctor. No quiero que la cura sea peor que la
enfermedad.
Dr. Flowers: These risks are highly unlikely. Most people just have a sore or swollen arm
for two or three weeks after placing the catheter.

Mr. Castro: Bueno, si eso va a aliviar su incomodidad con las jeringuillas, y crees que es
mejor, pues entonces estoy de acuerdo.

Dr. Flowers: Yes, Mr. Castro. Long-term is going to save him a lot of discomfort. I need you
to sign this consent form, so we can place a PICC line to your son.

Mr. Castro: No hay problema, doctor. ¿Y eso se va a hacer hoy o tengo que pedir cita?
Dr. Flowers: We can do it today in about 30 to 45 minutes. Afterward, a nurse will come in
to explain to you how to take care of your son’s PICC line at home.

Mr. Castro: Muy bien. Muchas gracias, doctor.