Butterfly iQ Ultrasound

This post should serve as a really brief, initial impressions review of a new bit of tech I’ve added to my kit.

The Butterfly iQ is an FDA cleared point of care ultrasound unit with a number of major advantages over previously available units. Unlike typical units which use piezo crystals to create the sound frequency to scan a given body area and therefore one must have different probes to do different exams the Butterfly iQ simulates the crystals through magic… or science… or both. End result is a more durable and less expensive unit than had been previously available.

The Butterfly iQ probe and app was developed to work with iOS devices. I spoke to one of their reps at SOMA 2019 and he stated an Android app is underdevelopment so once that is released the USB-C version of the Butterfly probe would work with Android devices that use USB-C.

I’ve got an iPad Mini 2 which I had hoped would provide a bigger screen than the iPhones 7 or XS, but the mini is not supported.

Quick thoughts based on a few uses at home.

Pros:
Probe feels very sturdy and is easy to clean
App fires up and connects to the probe in under 3 seconds
Interface in the app is intuitive, switching exams and modes is quick
The wireless Qi charging is great and since it uses the Qi charger an iPhone can be charged off the included charger and should one damage/lose the included charger one can purchase a generic Qi charger to replace it

Cons:
I wish the cable was removable from the probe – this would allow it to pack a little smaller and would also mean that if the cable was damaged replacing it would be super easy

Bridge to Health, a great NGO, took several Butterfly units on a trip to Uganda and the work was documented by the New York Times. The units allowed for a variety of exams to be performed and functioned well in the austere environment.

Here’s how I’ve setup my kit.

The reference cards are from Academic Life in Emergency Medicine.

The case is the UniCase made by SP Gadgets available on Amazon and REI (where I purchased it). The case offers a decent bit of impact resistance and a fair degree of water resistance. When the case zips closed it pulls shut a plastic gasket which appears to function quite well. I wouldn’t consider this waterproof, but I wouldn’t be worried about the contents if the outside got a bit wet.

I am using my old iPhone, an iPhone 7 setup as a dedicated device with the Butterfly iQ app and some medical references. My daily use iPhone has the Butterfly iQ app loaded as well.

The case will also fit several syringes and a vial of bupivicaine if you wanted to do nerve blocks.

Update:

My first serious usage of the Butterfly was with an NGO working in South America. The overall mission for the NGO was included providing classroom education for hospital staff and working at the bedside with their providers.

Team members were placed in the hospital based on their specialties. I was in Accident and Emergency (A&E) which is their term for an Emergency Department.

One of the first patients I saw was experiencing significant hemorrhage due to a spontaneous abortion. The highest priorities in her care were controlling the hemorrhage and gaining IV access so that a blood transfusion could be started. After several unsuccessful IV attempts by the hospital staff and me I gave IV access with the Butterfly unit a try.

I quickly found a deeper vein that I attempted to cannulate. I couldn’t see the needle penetrating the vessel as I had hoped, but I advanced my needle until I had flash. LR was started while the lab performed a type and crossmatch.

My team included a radiologist who brought a portable GE US unit. He ended up loving the Butterfly and immediately signed up to buy one when he got stateside. During the trip he used the Butterfly far more than I did. He did a variety of exams including vascular, obstetric, FAST, musculoskeletal, and cardiac. He was impressed with the image quality and versatility of the device.

The radiologist had brought a number of gel packets rather than the larger bottle I have. The packets definitely fit better in the case than the bottle.