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The Speed of Sound

Portable US

The Pros Far Outweigh the Cons

Butts, Christine, MD

doi: 10.1097/01.EEM.0000554852.18411.28
The Speed of Sound

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Like every other ultrasound nerd on earth, I love the idea of a portable ultrasound that has great image quality and is durable and much less expensive than a standard unit, so I was intrigued when I first heard about the Butterfly iQ.

And what? It serves as a low- and high-frequency transducer? Sold! Where do I sign?

I purchased one of these devices with my own money, and have used it on a few clinical shifts. The device costs just under $2000, and the user license and access to cloud storage for images and videos add $35 a month for a single user, though several people can share the cloud. Butterfly is only compatible with the Apple iPhone and iPad at this time, and you will have to download its free app. It comes with a one-year warranty, with the option to purchase additional coverage.

So what's good about it? First, it's very easy to set up. I'm not a technical person, and I was scanning within a few minutes. The image quality is great for a portable device. I used my iPhone to scan and didn't really notice that I was working with a smaller screen. It's convenient, and switching between applications (cardiac, abdomen, soft tissue, etc.) is smooth and easy. This was probably my favorite thing about it: I switched from examining one patient's kidney to her leg with one tap of the screen. The battery life is good. I used it off and on for two shifts, and it didn't run low. It also doesn't drain your phone battery.

What's not so good about it? It's heavier and slightly bulkier than a traditional transducer. It weighs 0.65 pounds in contrast to my iPhone 8, which weighs 0.4 pounds. It can be slightly cumbersome to manipulate the controls, which are touch screen, because you use one hand to hold the transducer and the other to hold the phone. I found this easier with some practice.

I have not yet tried to perform ultrasound-guided procedures with the Butterfly, but this might be slightly more cumbersome. The presets are not totally intuitive (what's the difference between abdomen and bladder?), and I'm still experimenting with those. I don't typically wear a white coat at work, so carrying the transducer, my phone, and a bottle of gel was a bit unwieldly. A case is not included, and I'm still experimenting with the best way to carry it.

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My overall take on this device? The pros far outweigh the cons, and it's extremely easy to use. I can see myself using this on shift in our ED, in teaching, and when working overseas. It's worth the price, especially for physicians who regularly work in an ED without a good, reliable ultrasound machine.

Learn more about the device, including its revolutionary silicone chip design, at www.butterflynetwork.com.

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Dr. Butts is the director of the division of emergency ultrasound and a clinical assistant professor of emergency medicine at Louisiana State University at New Orleans. Follow her on Twitter @EMNSpeedofSound, and read her past columns at http://bit.ly/EMN-SpeedofSound.

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