In the patient classifiable as DIVA (superficial veins of the upper limb not well visible or palpable), a peripheral venous access of short duration can sometimes be obtained by resorting to superficial veins of the neck (external jugular vein) or to superficial veins of the lower limb.
This practice is admissible only when it is certain that the device will be removed within a few hours (for example for the duration of a surgical procedure or a radiological exam); in fact, the cannulas positioned in the superficial tract of the external jugular vein have an elevated risk of dislocation and obstruction, while the cannulas positioned in the lower limbs have an elevated risk of thrombosis (and subsequent pulmonary embolism).
In some cases of DIVA, the use of NIR technology can be useful for a better visualization of the superficial veins: this technique - more frequently used in the newborn or in the infant - is not however always crowned with success in the adult patient.
In many cases of DIVA, therefore, it will be good to resort to an ultrasound guided venous access.