In the adult patient with DIVA, even outside of emergency-urgency situations, a device for peripheral venous access can be positioned with relative ease by resorting to ultrasound-guided puncture and cannulation of the deep veins of the arm or forearm.
Many peripheral access devices can be used for this purpose: short peripheral cannulas, long peripheral cannulas (mini-midlines) and midlines.
In practice however, the short cannulas inserted by ultrasound guidance in deep veins of the upper limb tend to have a very short duration (often not reaching 24 hours) and are associated with a high risk of dislocation and extravasation.
On the other hand, traditional midlines are mainly indicated in the non-hospitalized patient.
The safest and most cost-effective alternative in these cases is therefore represented by ultrasound guided insertion of mini-midlines (long peripheral cannulas).