OBJECTIVE: This study aimed to evaluate the difficult intravenous access (DIVA) score, a clinical prediction rule, which states that children with a score of 4 or more will have a 50% higher rate of a failed intravenous placement on the first attempt compared with the mean failure rate. METHODS: This was a prospective cohort study in children 0 to 14 years, undergoing peripheral intravenous placement by doctors in the emergency department of a medium-sized general hospital. Before intravenous placement attempts, demographic data inclusive of age and DIVA score were recorded. A maximum of 3 attempts per doctor were allowed, after which a more senior doctor undertook subsequent attempts. The site of successful placement was recorded. RESULTS: Five hundred children were enrolled. The male-female ratio was 1.3:1. One hundred thirty-three (26.6%) were less than 1 year, 103 (20.6%) were aged 1 to 2 years, and 264 (52.8%) were 3 years or older. One hundred ten children (22%) had a failed intravenous placement on the first attempt. Of the 151 children with a DIVA score of 4 or more, 57 (37.7%) had a failed intravenous placement, validating the clinical prediction rule. Only 5 subjects (1%) did not have intravenous placement after 6 attempts. CONCLUSIONS: This study validates DIVA score and provides a simple tool that can enhance the accuracy of the information offered to parents as it relates to the success rates of intravenous placement in children.
OBJECTIVE: This study aimed to evaluate the difficult intravenous access (DIVA) score, a clinical prediction rule, which states that children with a score of 4 or more will have a 50% higher rate of a failed intravenous placement on the first attempt compared with the mean failure rate. METHODS: This was a prospective cohort study in children 0 to 14 years, undergoing peripheral intravenous placement by doctors in the emergency department of a medium-sized general hospital. Before intravenous placement attempts, demographic data inclusive of age and DIVA score were recorded. A maximum of 3 attempts per doctor were allowed, after which a more senior doctor undertook subsequent attempts. The site of successful placement was recorded. RESULTS: Five hundred children were enrolled. The male-female ratio was 1.3:1. One hundred thirty-three (26.6%) were less than 1 year, 103 (20.6%) were aged 1 to 2 years, and 264 (52.8%) were 3 years or older. One hundred ten children (22%) had a failed intravenous placement on the first attempt. Of the 151 children with a DIVA score of 4 or more, 57 (37.7%) had a failed intravenous placement, validating the clinical prediction rule. Only 5 subjects (1%) did not have intravenous placement after 6 attempts. CONCLUSIONS: This study validates DIVA score and provides a simple tool that can enhance the accuracy of the information offered to parents as it relates to the success rates of intravenous placement in children.
Authors: Peter J Carr; James C R Rippey; Marie L Cooke; Chrianna Bharat; Kevin Murray; Niall S Higgins; Aileen Foale; Claire M Rickard Journal: BMJ Open Date: 2016-02-11 Impact factor: 2.692
Authors: Hamid Shokoohi; Michael A Loesche; Nicole M Duggan; Andrew S Liteplo; Calvin Huang; Ahad A Al Saud; Dustin McEvoy; Shan W Liu; Sayon Dutta Journal: J Am Coll Emerg Physicians Open Date: 2020-08-19
Authors: Jessica A Schults; Tricia M Kleidon; Victoria Gibson; Robert S Ware; Emily Monteagle; Rebecca Paterson; Karina Charles; Adam Keys; Craig A McBride; Steven McTaggart; Benjamin Lawton; Fiona Macfarlane; Chloe Sells; Claire M Rickard; Amanda J Ullman Journal: BMC Health Serv Res Date: 2022-02-17 Impact factor: 2.655
Authors: J M López Álvarez; O Pérez Quevedo; L Santana Cabrera; C Rodríguez Escot; J F Loro Ferrer; T Ramírez Lorenzo; J M Limiñana Cañal Journal: J Ultrasound Date: 2017-11-14