LOVE-DIVA Trial: Improving First-Insertion Success for Patients with Difficult Venous Access in the Emergency Department: a study protocol for a randomized controlled trial

Introduction:
Peripheral vascular access is a common procedure in emergency departments (EDs), but it can be challenging for patients with difficult venous access (DIVA). The LOVE-DIVA trial aims to investigate whether a long peripheral intravenous catheter (PIVC) with a retractable guidewire can improve first-insertion success rates for these patients.

Background:
First-insertion success for peripheral vascular access devices (PVADs) is crucial in minimizing patient discomfort, reducing staff workload, and lowering healthcare costs. However, patients with DIVA often experience low first-insertion success rates, leading to repeated attempts and increased complications.

Objective:
The LOVE-DIVA trial seeks to determine whether using a long guidewire PIVC (GW-PVAD) can improve first-insertion success compared to standard PVADs in patients with DIVA in the ED setting.

Methods:
1. Study Design: A parallel-group, two-arm randomized controlled trial will be conducted in two Australian EDs.
2. Participants: The trial will include patients aged 18 years and older who meet the DIVA criteria.
3. Interventions: Participants will be randomly assigned to receive either a long GW-PVAD (5.8 cm) or a standard PVAD (short or long).
4. Outcomes: The primary outcome is the first-insertion success rate. Secondary outcomes include the number of insertion attempts, time to insert PVAD, all-cause failure, dwell-time, patient-reported pain, serious adverse events, complications, subsequent vascular access devices required, patient satisfaction, staff satisfaction, and healthcare costs.

Conclusion:
The LOVE-DIVA trial addresses a critical challenge in emergency care by exploring whether a long GW-PVAD can optimize first-insertion success for patients with DIVA. The results could lead to improved patient outcomes, enhanced clinician satisfaction, and reduced healthcare costs.

Authors: Hui (Grace) Xu, Amanda Corley, Robert S. Ware, Son Nghiem, Scott Stirling, Carrie Wang, Nicole Marsh

Read More: https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2024.33.7.S28?journalCode=bjon