Question for anyone with a Butterfly iQ

[combatwombat]

The Buterfly website mentions that if you let your subscription run out, you can still use the probe but won't be able to upload images to their cloud. I was wondering if, after this period, you can still save images by taking a screenshot with your Apple device (e.g. by pressing home and power buttons simultaneously)? Or does it effectively become impossible to save any images?

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[nimbus]

Yes I’ve done exactly that.

Kinda roundabout but you can screenshot—>email or text image to 2nd device—>take haiku photo off the screen of the 2nd device or print and scan image into medical record.

Biggest impediments for lines/blocks are the large footprint and the general bulkiness of the Butterfly compared to other ultrasound probes.

 

[anaesthetic]

.

 

[nimbus]

Has anyone had any experience using the Butterfly iQ for PNBs or arterial/central line placement (sterile sleeve, etc.)? I've had issues with having reliable access to ultrasound machines around the hospital, and it would be nice to just have a personal one readily available. Also interested in the Philips Lumify, but those transducers cost 3x more and are Android-compatible only.

Works fine for those applications with the caveat that the wide footprint of the butterfly makes needling superficial structures more difficult. For example, if you are doing an out of plane USG aline on a very superficial radial artery, your needle tip will often not appear in the scanning plane until you are already deep to the artery. You have to adjust the technique to go in at a much shallower angle. Deeper structures are no problem.

 

[deleted875186]

Works fine for those applications with the caveat that the wide footprint of the butterfly makes needling superficial structures more difficult. For example, if you are doing an out of plane USG aline on a very superficial radial artery, your needle tip will often not appear in the scanning plane until you are already deep to the artery. You have to adjust the technique to go in at a much shallower angle. Deeper structures are no problem.

I thought this when I did the demo with this probe. Probably ok for most arterial and venous access,but probably difficult for some shallow structures. Seems like doing anything in the spraclavicukar area would be challenging.

 

[vector2]

Works fine for those applications with the caveat that the wide footprint of the butterfly makes needling superficial structures more difficult. For example, if you are doing an out of plane USG aline on a very superficial radial artery, your needle tip will often not appear in the scanning plane until you are already deep to the artery. You have to adjust the technique to go in at a much shallower angle. Deeper structures are no problem.

Where are you placing your phone when doing lines and blocks?

 

[nimbus]

Where are you placing your phone when doing lines and blocks?

On top of a blanket on top of the patient.

 

[HalO'Thane]

Has anyone had any experience using the Butterfly iQ for PNBs or arterial/central line placement (sterile sleeve, etc.)? I've had issues with having reliable access to ultrasound machines around the hospital, and it would be nice to just have a personal one readily available. Also interested in the Philips Lumify, but those transducers cost 3x more and are Android-compatible only.

My experience with the Phillips Lumify has been that it is purely a phased array probe; meaning it is really only useful for Cardiac imaging and possibly other deeper structures. I don't think it would be useful for lines and blocks as I believe it doesn't have a linear component needed for imaging superficial structures.

The Butterfly, in contrast, is designed to be adjustable and allow for blocks and access when zoomed in and viewing deeper structures, such as the Heart and Gastric Antrum, when zoomed out.

 

[abolt18]

Multiple attendings have the butterflyIQ and there are a few owned by the department. They have been a big hit! I personally haven't used them but people seem more than satisfied with the picture and versatility when compared to the price.

 

[OneTyme]

Love mine.

Use it for everything.

The footprint can get in the way, but it isn’t so bad once you get used to it.

 

[Guillemot]

I have a butterfly IQ. Its good for what it is, but wont replace a dedicated machine and probes. I use it enough though that I feel it was well worth the purchase price with my own $. Not worth paying 500/year for the subscription though (for me). I use it mostly for vascular access and focused echocardiograpy.

 

[AnesRunner]

I have been disappointed with my iQ. Bought it for POCUS teaching, for which it is OK. For anything needing higher resolution (blocks, vascular access, etc.), it just doesn't compare. Hopefully, one day, their technology improves. I haven't used the Lumify, but the Clarius is great in terms of resolution (minus the unfortunate bulkiness).

 

[Guillemot]

I have been disappointed with my iQ. Bought it for POCUS teaching, for which it is OK. For anything needing higher resolution (blocks, vascular access, etc.), it just doesn't compare. Hopefully, one day, their technology improves. I haven't used the Lumify, but the Clarius is great in terms of resolution (minus the unfortunate bulkiness).

Lumify has better image quality than Butterfly. Keep in mind that you would need both the phased array and linear Lumify probes for cardiac and vascular access/blocks respectively. Therefore cost would be much higher and portability lower with Lumify.

 

[anes121508]

My experience with the Phillips Lumify has been that it is purely a phased array probe; meaning it is really only useful for Cardiac imaging and possibly other deeper structures. I don't think it would be useful for lines and blocks as I believe it doesn't have a linear component needed for imaging superficial structures.

The Butterfly, in contrast, is designed to be adjustable and allow for blocks and access when zoomed in and viewing deeper structures, such as the Heart and Gastric Antrum, when zoomed out.

what's the pricing on the lumify? the iq shows 1999$ on the website.

 

[HalO'Thane]

what's the pricing on the lumify? the iq shows 1999$ on the website.

When I had inquired I had only received quotes for leasing the Lumify, which was $200 per month for the phased array. The nice thing is that you can return it anytime you wish. I actually do not know how much it is to purchase the Lumify probe but I’m sure it is much more expensive than the IQ. I believe that the IQ is by far the cheapest portable ultrasound out there.

 

[WheezyBaby]

Our EM pocus folk think the lumify is worth the extra money fwiw

 

[sevoflurane]

Don’t you need to subscribe to a plan with the butterfly? I think that is pricey as well.

 

[HalO'Thane]

Don’t you need to subscribe to a plan with the butterfly? I think that is pricey as well.

I don’t believe you have to. I think the subscription allows you to save your images on their cloud, which I suppose would be useful if you are a cardiologist, radiologist, or EM doc. For us my guess is we don’t routinely need to save images. I think you are required to purchase a subscription for the first year but I don’t think there is any drawback to letting it expire after that year. The Butterfly should still be functional after that.

 

[sevoflurane]

Yup. That is my understanding as well. One of my partners has one. I have been on the fence on the purchase.
So initial costs are like $2500.

 

[Hork Bajir]

I borrowed one from a buddy to try it out, and it seemed like the probe overheated very quickly. Couldn’t scan for more than 30 seconds to a minute at a time without it needing to pause for heat dissipation - was I using a lousy probe, or is this an issue for others who owns the IQ?

 

[T-burglar]

How is it for arterial access?

 

[DM27]

We were between the Lumify and the Butterfly IQ for POCUS/FATE type activities in the PACU and Pre-Op area. I was a huge fan boy of the Butterfly initially until they released the full details (subscription, etc.) and I got more experience with the image quality. This information is from when I went through this probably 9 months ago so maybe some things have changed.

The Butterfly required a subscription to their cloud image storage servers and what have you. The Butterfly was decent for lung ultrasound, vascular access (mainly larger vessels and arterial access), ok for abdominal ultrasound. The TTE/Cardiac imaging was lacking, resolution was not great and kind of an eye-squinting qualitative assessment.

I found the Lumify to be overall better across the board in terms of imaging, for us the quote for buying the Lumify outright, which came with a iPad-like tablet as well was around $7,000. This price will vary hugely based on your institution.

The deal-breakers that made us go with the Lumify over the Butterfly were the following:

1) Lumify had overall superior image quality, especially with the FATE/TEE aspect compared to the Butterfly, this was where it really mattered.
2) The Butterfly subscription service was mandatory and was deemed "not worth" the trouble by IT of having to work it into out network and people did not like the idea of images being stored on a cloud server that was Butterfly's, and our device/budgeting committee was not willing to pay for a mandatory subscription plan that we had deemed we would or could not use.

I did not experience actual overheating but the probe does get surprisingly hot (like an old laptop charger).

 

[Guillemot]

I borrowed one from a buddy to try it out, and it seemed like the probe overheated very quickly. Couldn’t scan for more than 30 seconds to a minute at a time without it needing to pause for heat dissipation - was I using a lousy probe, or is this an issue for others who owns the IQ?

I have not had this issue. Something might be wrong with the probe you were using. I'd imagine that the type of scanning might impact the heat generated though (eg color doppler probably generates more heat).

 

[Guillemot]

We were between the Lumify and the Butterfly IQ for POCUS/FATE type activities in the PACU and Pre-Op area. I was a huge fan boy of the Butterfly initially until they released the full details (subscription, etc.) and I got more experience with the image quality. This information is from when I went through this probably 9 months ago so maybe some things have changed.

The Butterfly required a subscription to their cloud image storage servers and what have you. The Butterfly was decent for lung ultrasound, vascular access (mainly larger vessels and arterial access), ok for abdominal ultrasound. The TTE/Cardiac imaging was lacking, resolution was not great and kind of an eye-squinting qualitative assessment.

I found the Lumify to be overall better across the board in terms of imaging, for us the quote for buying the Lumify outright, which came with a iPad-like tablet as well was around $7,000. This price will vary hugely based on your institution.

The deal-breakers that made us go with the Lumify over the Butterfly were the following:

1) Lumify had overall superior image quality, especially with the FATE/TEE aspect compared to the Butterfly, this was where it really mattered.
2) The Butterfly subscription service was mandatory and was deemed "not worth" the trouble by IT of having to work it into out network and people did not like the idea of images being stored on a cloud server that was Butterfly's, and our device/budgeting committee was not willing to pay for a mandatory subscription plan that we had deemed we would or could not use.

I did not experience actual overheating but the probe does get surprisingly hot (like an old laptop charger).

I agree with your assessment of Butterfly. Subscription is mandatory only for the first year though and can subsequently be dropped.

I still benefit from having the ability to perform vascular access and focused TTE in one probe based on my hospital environment. Eg need to place emergency vascular access on hemorrhaging, obese, edematous patient located on floor where no linear US are located.

Also the level of detail I go into on my focused exams isn't that high. Mainly use for resuscitation guidance of an unstable patients: IVC dynamics, full vs empty heart, significant WMA, Good sqeeze vs poor, relative chamber size). I think my exams are likely impeded to a greater extent by patient habitus than a better probe though. I look forward to future improvements in subsequent iterations of butterfly. If butterfly's imaging & features were better I might try to learn more and do more sophisticated exams in cardiac.

 

[lane]

I’ve owned a butterfly since last February and have used it for blocks (ISB, SCB, TAP, QL, adductor canal), arterial and venous access, and a quick TTE. I have used it with both a iPhone XS Max and an iPad. Obviously the quality is not the same as a dedicated Sonosite, but for a portable ultrasound the quality has been more than adequate.

 

[Katheudontas parateroumen]

Is the butterfly or any of the other probes capable of doing things like VTI?

 

[Guillemot]

Is the butterfly or any of the other probes capable of doing things like VTI?

AFAIK, no.

 

[AdmiralChz]

Is the butterfly or any of the other probes capable of doing things like VTI?

To do so it would have to be able to do PW or CW which I believe is a no, but honestly not positive.