Adult difficult IV access (A-DIVA) score

Risk factor	Points
Known history of difficult IV access	1
Do you expect a failed first attempt or difficult IV access?	1
Unable to identify a dilated vein by palpating the upper extremity^*	1
Unable to identify a vein by visualizing the upper extremity^*	1
Does the largest dilated vein have a diameter <3 mm?^*	1
A-DIVA score (total points)	Failed first attempt rate
0 to 1	4%
2 to 3	37%
4 to 5	94%

The A-DIVA score is the total number of 'yes' answers.

IV: intravenous.

* After tourniquet placement.

Adapted from: van Loon FHJ, van Hooff LWE, de Boer HD, et al. 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. J Clin Med 2019; 8:144. Copyright © The Authors. Available at https://www.mdpi.com/2077-0383/8/2/144 (Accessed on September 14, 2022). Reproduced under the terms of the CreativeCommons Attribution License 4.0.

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Adult difficult IV access (A-DIVA) score