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Difficult IV Access

Additional Challenges for Difficult IV Access

Patients with difficult intravenous access (DIVA) present a growing challenge to nurses. Learn more about the special consideration needed when selecting vascular access devices and preparing for insertion for these types of patients.

What Causes Difficult IV Access?

Ultrasound Guidance for Increased Vein Visualization of DIVA Patients
The True Costs of IV Restarts

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References

1. Shokoohi H, Loesche MA, Duggan NM, Liteplo AS, Huang C, Al Saud AA, McEvoy D, Liu SW, Dutta S. Difficult intravenous access as an independent predictor of delayed care and prolonged length of stay in the emergency department. J Am Coll Emerg Physicians Open. 2020 Aug 19;1(6):1660-1668. doi: 10.1002/emp2.12222. PMID: 33392574; PMCID: PMC7771794.

2. Paldini A. et al. Ultrasound-guided placement of long peripheral cannulas in children over the age of 10 years admitted to the emergency department: a pilot study. BMJ Paediatrics Open. (2018) https://doi.org/10.1136/bmjpo-2017-000244

3. Rodriguez-Calero, M. A. et al. Defining risk factors associated with difficult peripheral venous cannulation: A systematic review with meta-analysis. Heart & Lung. (2020) https://doi.org/10.1016/j.hrtlng.2020.01.009

4. Nafiu, O. O. MD, FRCA. et al. Comparing peripheral venous access between obese and normal weight children. Pediatric Anesthesia. (2010) https://doi.org/10.1111/j.1460-9592.2009.03198.x

5. Helm, R. E. MD. et al. Accepted but Unacceptable: Peripheral IV Catheter Failure. The Art and Science of Infusion Nursing. (2015) https://doi.org/10.1097/NAN.0000000000000100

6. Crowley, M., MSN, RN, CEN, MICN. et al. Emergency Nursing Resource: Difficult Intravenous Access. Emergency Nurse Journal (2012) https://doi.org/10.1016/j.jen.2012.05.010

7. Van Loon FH, Van Hooff LW, de Boer HD, Koopman SS, Buise MP, Korsten HH, Bouwman AR. The modified A-DIVA scale as a predictive tool for prospective identification of adult patients at risk of a difficult intravenous access: A multicenter validation study. Journal of Clinical Medicine. 2019;8(2):144-156