Pediatric difficult intravenous access score
“This study provides external validation data for DIVA3 and DIVA4 scores in the LMIC setting. The novel modified 4-variable LMIC-DIVA score improves test characteristics and accuracy in identifying pediatric DIVA in our population” Kanjanauptom et al (2025).
Infrared illumination for difficult peripheral venous catheterisation – Full Text
“Our hypothesis is that infrared vein illumination could improve the success rate of peripheral venous catheterisation in critically ill patients at risk of difficult catheterisation” Ouedraogo et al (2025).
Predicting difficult intravenous access in adult patients
“Constructing a risk prediction model for DIVA in adult patients has significant predictive value. It assists medical staff in early intervention and management for high-risk patients, thereby achieving effective prediction, warning, and control” Ji et al (2025).
Ultrasound-guided cannulation for difficult IV access
“Based on these results, USGPIV cannulation improves the likelihood of first-attempt insertion success in patients with DIVA” Owen et al (2025).
Adult difficult intravenous access scale translation into Brazilian Portuguese – Full Text
“To cross-culturally adapt and analyze the metric properties of the Adult Difficult Intravenous Access Scale into Brazilian Portuguese” Monteiro et al (2025).
Enhanced adult DIVA score in an emergency department
“The EA-DIVA scale, originally validated in a preoperative setting, was effectively implemented for the first time in the ED. This study established a lower cutoff score for expert intervention utilizing ultrasound guidance compared with previous applications of the EA-DIVA scale” Petta et al (2025).
Venipuncture in oncology patients with difficult venous access – Full Text
“Provision of a smaller gauge UT-PBBCS option during phlebotomy in oncology patients with DVA reduces procedural pain and anxiety and improved phlebotomist’ experience during sample collection” Giussani et al (2024).
Difficult intravenous access in the paediatric emergency department – Full Text
“The present study identified multiple patient, proceduralist and situational factors that were associated with DIVA in the paediatric ED” Dunstan et al (2024).
Difficult IV access research study protocol
“The aim of this study is to investigate whether the use of long GW-PVADs, compared with standard PVADs, reduces the risk of first-time insertion failure, in patients admitted to emergency departments (EDs)” Xu et al (2024).
Predicting difficult intravascular access – Full Text
” Ask (about a history of DIVA or IV drug abuse), Feel, and Evaluate BMI. By recognizing patients with DIVA before the first insertion attempt and treating them from the outset with advanced vein visualization techniques, patients with DIVA could be subject to less frequent painful venipunctures, fewer delays in treatment, and a reduction in other DIVA-associated burdens” Bahl et al (2024).
Peripheral internal jugular venous catheters
“We describe the results of 2 years’ experience from a pilot project of a medicine procedure service placing PIJ catheters in hospitalized patients with DIVA” Heath et al (2023).
Ultrasound assisting peripheral IV access in pediatric DIVA patients – Full Text
“Our study showed that bedside ultrasound assisting implantation of peripheral venous access in pediatric DIVA patients improves first-time success rate, overall success rate, procedural time, and patient comfort, reducing the number of attempts to obtain a stable IV line” D’Alessandro et al (2023).
Paediatric DIVA in the emergency department survey – Full Text
“There is currently no consistent process for the identification and escalation of paediatric DIVA patients, including the use of adjuncts such as POCUS” Lam et al (2023).
Evaluation of extended-length peripheral IV cannula
“This article reports on the results of introducing extended-length PIVCs, inserted using ultrasound guidance in patients with DIVA by a vascular access team” Smith and Irimia (2023).
Long peripheral IV catheter in DIVA patients
“The aim of the study was to evaluate whether ultrasonography can be useful for the selection of the suitable LPC in DIVA (difficult intravenous access) patients” Lisova et al (2023).
Insertion of pediatric CVC in adults with difficult IV access
“PIPCVC placement seems to be a feasible option in patients in whom peripheral intravenous access is difficult. The safety of this technique needs to be evaluated in prospective studies” Chalela et al (2023).
Improving difficult peripheral intravenous access research protocol – Full Text
“Study findings will help define systematic solutions to implement DIVA identification and escalation tools aiming to address consumer dissatisfaction with current PIVC insertion practices” Schults et al (2023).
Child experience of difficult venous access – Full Text
“Multiple attempts to insert a peripheral intravenous catheter are a source of substantial distress for children/young people, leading to treatment avoidance” Sharp et al (2023).
DIVA evidence-based cognitive aid prototype – Full Text
“The adult DIVA cognitive aid is intended for use in both elective and emergency scenarios by practitioners adequately trained in ultrasound-guided or ultrasound-assisted vascular access and Seldinger-based techniques” Stagg (2023).
Impact of ultrasound guidance on first-attempt peripheral IV cannulation success
“The use of ultrasound guidance resulted in an almost three-fold increase in odds for the first-attempt success rate in patients with predicted DIVA compared with the traditional technique of PIVC” Poulsen et al (2023).
Difficult intravenous access scoring in pediatric patients
“None of the 4 DIVA scoring tools were superior in predicting first-time PIV placement among hospitalized children. Vein palpability was more predictive, although not statistically significant” Kanaley et al (2023).
Management of difficult intravenous access
“As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other “tricks-of-the-trade” and pearls for overcoming DIVA are mostly relegated to informal nonpublished material” Ng et al (2022).
Modified DIVA Score
“The m-DIVA score, which incorporates prior history, increases the screening test’s sensitivity in identifying “difficult access” patients and should be further investigated as clinical tool” Rizvi et al (2022).
Successful pediatric peripheral IV catheterization – Full Text
“Difficulty in setting up PIVC was the greatest in infants and even greater than that in newborns” chu et al (2022).
Difficult intravenous access in children – Full Text
“We identified statistically significant variables related to difficult IV cannulation in children, which we used to develop a prediction tool to assess the likelihood of difficult IV access in pediatric patients” Al-Awaisi et al (2022).
DIVA – difficult intravenous access – Full Text
“This narrative review reports on the burden of difficult venous access situations and discusses the evidence, and strengths and limitations of vascular access options to help address this challenge” Little et al (2022).
Transillumination device for difficult peripheral IV access
“To compare the utility of transillumination device with traditional vein viewing in situations with difficult peripheral venous access in pediatric patients” Dutt et al (2022).
Ultrasound guided peripheral IV insertion – Full Text
“We identified a number of implementation strategies to support future ultrasound and DIVA pathway implementation” Schults et al (2022).
DIVA in children with short bowel syndrome – Full Text
“We searched the literature to highlight the current management of children with vascular exhaustion, specifically focusing on vascular access salvage strategies and last-resource alternative routes to central veins” Grimaldi et al (2022).
Ultrasound guided peripheral IV access for DIVA patients – Full Text
“This study utilized a scoping review methodology to map the literature pertaining to non-physician use of POCUS to improve success of peripheral intravenous access (PIVA), especially in patients predicted to be difficult to cannulate” Burton et al (2022).