Development and validation of a scale to predict the risk of failure on the first attempt of inserting an intravenous peripheral catheter

The primary outcome variable was defined as failed peripheral IV catheterization on the first attempt. An attempt was defined as when the needle first touches the skin until the needle was removed from the skin. A new attempt was defined as any change in vessel localization, followed by a new skin puncture. For development of the A-DIVA score, following patients’ characteristics were collected: sex, age, weight, length, body mass index, skin shade, dominant site, tympanic temperature, whether or not the patient received premedication and if it was difficult to achieve and IV access in the past. These data were collected prior to the procedure, by asking the patient or from the preoperative anesthesia screening form. Procedure-related factors were registered prior to or after insertion of an IV catheter: skin shade, size of the cannula, side of the cannulation, place of cannulation on the extremity, size of the stewed vein in millimeters, pain score after every puncture on an eleven-points NRS scale (score 0 is no pain en score 10 is the worst imaginable pain), number of attempts needed for successful IV cannulation, whether or not the vein was palpable and/or visual before puncture (answered with yes or no) and the years of experience of the NA. After the procedure, patients historical and physical status were collected by asking the patient or from the preoperative anesthesia screening forms: sex, length, weight, BMI and special attention was paid to (chronic) diseases, IV drug abuse, vessel diseases, hematological status and the use of medications.