What is the best ultrasound machine and why?

[Oggg]

I am in private practice and the hospital budget is tight. We currently have one of the oldest M-Turbos from Sonosite. It has a L38 linear probe and the C60 curved probe. Currently it's shared between us and the surgeons (cardiac and vascular mostly). Now that we're gearing up to do CFNB and other nerve blocks, I have been pushing for us to get a HFL linear probe and the needle enhancement software. Does anyone have experience with other ultrasound machines (GE, other?)? The Sonosite rep was pushing the S-Nerve system as well.

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[PMPMD]

I am in private practice and the hospital budget is tight. We currently have one of the oldest M-Turbos from Sonosite. It has a L38 linear probe and the C60 curved probe. Currently it's shared between us and the surgeons (cardiac and vascular mostly). Now that we're gearing up to do CFNB and other nerve blocks, I have been pushing for us to get a HFL linear probe and the needle enhancement software. Does anyone have experience with other ultrasound machines (GE, other?)? The Sonosite rep was pushing the S-Nerve system as well.

It sounds like you're asking what the best U/S unit is for the money.

Our dept has a GE unit thats several years old and works very well.

Our SICU just gota brand new Philips machine that's awesome. But definitely 6 figures.

 

[Oggg]

holy crap 6 figures!? Anyone have experience with the S-nerve?

 

[imfrankie]

holy crap 6 figures!? Anyone have experience with the S-nerve?

I like the Sonosite cause it boots up pronto. Good pictures, price is right, support good. I've used many. I aint pushin Sonosite, but I like em. Plus they overnighted me one to take on an international volunteer trip. Like the company. That's who I'd go with. I may buy a used one for myself on Craigs.

 

[IN2B8R]

Gotta agree with you, Sonosite is a far better machine than GE--that's based on my opinion and that of my partners (extensive regional practice). In particular, with the Sonosite linear probe, you have the capacity to see with greater resolution at >6-8cm depth. Good luck with having a similar resolution with the GE machine.... Moreover, Sonosite recently introduced new software that allows for better needle visualization, something that GE is lagging behind. I have no vested financial interest in either company and am merely commenting as such based on my (and my partners) extensive experience with these two brand names. I recently attended the ASRA meeting in Las Vegas and I can tell you that Sonosite definitely gave you more bang for your buck: a better product with better support. There obviously are other ultrasound machine makers out there, but I have no experience with their product. And that's my two cents!🙂

I like the Sonosite cause it boots up pronto. Good pictures, price is right, support good. I've used many. I aint pushin Sonosite, but I like em. Plus they overnighted me one to take on an international volunteer trip. Like the company. That's who I'd go with. I may buy a used one for myself on Craigs.

 

[bkadry]

www.u-blok.com

$6000
(Yes, 6 thousand dollars. It is a Honda Accord of Ultrasounds and it also sends your claim directly to your billing company with an attached picture)

The picture is not as clear as the $50,000 ultrasound machine but it is still great for:
interscalene
supraclavicular
infraclavicular
femoral
sciatic
saphenous

Also great for IJ and Femoral central lines.

Hope this helps!

Use Promotion Code:
"WaelToldMe" in your email: [email protected] to get a discount

 

[aneftp]

Consider buying a refurbished ultrasound machine. We did it for ours. I think it costs around $7K...new would have been close to $25-30K. Cheap SiteRite but it does the job.

If you know what you are doing, most basic machines will work. In all honesty, I really don't even need to use a nerve stimulator even with the cheap ultrasound. I just use it for medical legal documentation.

 

[Oggg]

the youtube videos on the U-Blok site look weird. I don't know if it's because of the zoom or if the resolution is crappy or what. Have you seen this machine in action? The interface sounds great, I'm just worried about the probe quality and resolution. There's not a lot of information about the probe itself on the site. It looks like it's one probe that can cycle through different frequency/depth combinations.

 

[pjl]

Any new or differing opinions? Our group has gotten to the point where just one machine is not enough. We would be looking for a machine for regional only.
We currently have a slightly older Sonosite M turbo, and are thinking of going with a new version of the same.
What are people's opinions of the improvement between generations, or that machine versus others?

 

[Oggg]

I tried out the new Sonosite EDGE with an HFL50 and it was really nice -- better than the M Turbo for sure. However, our m turbo with HFL38 works great for everything. We too want a new machine, and I'll be pushing for another m turbo.

 

[climbingak]

I have the S-Nerve. Its awesome for me. Hardly have to touch a button besides depth. I think it was around 40K. I got it with the HFL 50 and the low freq curvilinear for deeper blocks. I couldnt ask for a better machine if all you are doing is nerve blocks. Software is set up perfectly to enhance the nerve. Ive never used the Edge and assume this is their newest one.

I never use the needle enhancement technology. We have it, I just havent needed it.

 

[pjl]

How does the needle enhancement work for group members who are newer to U/S, and not very into technology? Is it difficult to turn on/use? Does anyone have less technologically savy partners who have given feedback? I am talking about people who spent a year using the current model in vascular mode before I arrived and changed the setting to nerve for them.
I feel like simple is good, and the needle enhancement is probably not that useful to me, but want to make their experience as good as possible so they are happier with the aquisition of an expensive piece of machinery.

 

[Oggg]

Press a button to toggle needle enhancement on and off. Needle must be in the little window that pops up. You can tell the computer if you're steep flat or in between. It may or may not help. Useless for out of plane approaches. If you apply good ultrasound technique and keep your needle flat all the time, you probably won't get much out of MBe. Maybe it will help for fat patients, TAP/TPVB in fatties, infraclav, high sciatics.

 

[powermd]

We have a GE Logiq that's about 5 years old. We're happy with it, but have decided to upgrade to the current model thanks to a good deal from GE. They have this little hockey stick probe we're buying as well that should be terrific for small joints and tendons. I think our original machine cost $35K, and the upgrade is costing us $10K with trade in. A major plus will be getting a new 5 year warranty, which we would otherwise have spent $15-20K on anyway for continued coverage on our old unit.

GE recently came by the practice and provided some optimization of our 4C probe settings that were tremendously helpful for seeing the hip, or the 8-10 cm deep PSIS in a fatty.

My partner recently checked out the current Sonosite and Mindray, and still thought the GE was better. I haven't personally used one of these.

Has anyone actually used one of the cheap Chinese machines and seen comparisons to the above units?

 

[deleted9493]

Agree with the above poster regarding the S-nerve...I have been using Sonosite's M-turbo and S-nerve units in residency and now in fellowship. They both provide a smooth picture. I'd prefer the S-nerve because it's 20k cheaper than the M-turbo and as a flat screen mounted is easy to transport and doesn't take as much space.

I have used a GE device a few times in fellowship and the picture generally seems relatively grainy with tissue contrasts that make soft tissue differentiation more difficult. That being said, I think I might prefer the GE device if I was in a vascular line of work...

 

[Oggg]

Anyone try any cheaper alternatives?

U-Blok seemed very promising - 6-24mhz on one usb probe, windows tablet, <$10k. But the image is funky, wedge shaped (like a vag/rectal probe image), no color Doppler, and did I mention the pictures look nothing like a Sonosite.

There are inexpensive options for mid to low frequency low res probes, but not much for high freq probes that we require for nerve blocks.

We've started to use our TEE beast (Siemens Acuson2000) for some nerve blocks because it has a hockey stick and a mid range linear probe. But the nerve exam presets aren't as good as the Sonosite.

 

[Salt Creep]

The MBE (needle enhancement software) on the S-nerve does work. I don't -need- it, but it has been helpful in showing my partners who are new to U/S where their needle is. There's no question that the needle shows up better with it on.

It's very easy to turn on/off. I think the S-nerve is perfect for regional. I trained on the M-turbo, and the S-nerve does everything I need in practice. And with the MBE, it does even more than the M-turbo could - esp for infraclav or deep sciatics.

 

[drccw]

S-nerve for us. I'm so stupid that I hate fiddling with stuff.. it's really really easy to use. One negative is that to change the probes you have to switch them out in the back.I've used the Micromaxx before and apprciate the ability to have multiple probes hooked up at once... (just click the button). but did I mention that the S-nerve is ridiculously simple and easy to use?

drccw

 

[TheSandMan]

Anyone try any cheaper alternatives?

U-Blok seemed very promising - 6-24mhz on one usb probe, windows tablet, <$10k. But the image is funky, wedge shaped (like a vag/rectal probe image), no color Doppler, and did I mention the pictures look nothing like a Sonosite.

There are inexpensive options for mid to low frequency low res probes, but not much for high freq probes that we require for nerve blocks.

We've started to use our TEE beast (Siemens Acuson2000) for some nerve blocks because it has a hockey stick and a mid range linear probe. But the nerve exam presets aren't as good as the Sonosite.

Our group is currently looking into an ultrasound machine ourselves. In talking to a rep who sells a few different brands of ultrasound machine, he said that the Mindray DP-50 is his most popular model he sells to anesthesia groups by far. It is a black and white model, so I assume doppler is out of the question, but I am not too concerned. Quoted price was 8K for the machine with probe.

Does anyone have any experience with this model or even with the Mindray brand in general?

 

[Oggg]

Doppler is pretty useful. Find out what probes the mindray supports. Last time I checked only the M7($$$) had a true high frequency linear probe 13mhz (need higher than 10)

 

[TheSandMan]

Doppler is pretty useful. Find out what probes the mindray supports. Last time I checked only the M7($$$) had a true high frequency linear probe 13mhz (need higher than 10)

Thanks for the reply Oggg. What is the benefit of higher frequencies? Will this benefit us with all types of blocks or just certain ones. For our outdated sonosite titan, the recommended nerve transducer (which we don't own) only has a range of 5-10mhz. Is this just a reflection of how old this model is?

 

[epidural man]

I am in private practice and the hospital budget is tight. We currently have one of the oldest M-Turbos from Sonosite. It has a L38 linear probe and the C60 curved probe. Currently it's shared between us and the surgeons (cardiac and vascular mostly). Now that we're gearing up to do CFNB and other nerve blocks, I have been pushing for us to get a HFL linear probe and the needle enhancement software. Does anyone have experience with other ultrasound machines (GE, other?)? The Sonosite rep was pushing the S-Nerve system as well.

The best machine is the one I use in the interventional radiology suite. I have no idea what it is and it is BIG - but the pictures are awesome. It also uploads my images to the PACS system which is also grand.

I hate the GE logiq. It takes forever to start up. It has 1000 knobs. When the rep comes, she makes the image looks amazing, but after 2 days, the knobs are all over the place and the image looks like crap and I can't for the life of me - get the good image back. Also, getting saved images off the machine is a nightmare.

I want something that I can turn on in less than 5-10 sec - looks nearly the same all the time. Has 3 buttons...Is lickety split getting saved images on my flash drive (and I don't have to have special software on my comp to read the damn thing).

Enter Sonosite. It does all that - and is built for toughness.

It has a smaller screen though. If you want a big screen, go with the GE.

 

[Oggg]

For central lines, the 10-5mhz probe is fine. We started out with that probe and I struggled to visualize nerves for many months. You can get the blocks done, but you don't feel good about your blocks a lot of them time, unless you have NS backup. Many people say the femoral block is fine with this probe. The 13-6 38mm probe is way better. I could see the nerves after injection quite well once we got this probe. The Sonosite hfl50 is 50mm wide and like 15-8mhz and is even better but we don't have one. All the good YouTube videos use the HFL 50 (on the screen, L50 is the hfl50 and HFL is the hfl38). Sonosite is expensive though.

If your TEE machine has a high freq linear probe, you can use that, but the TTE machines take forever to boot up and need to be plugged in.

 

[TheSandMan]

For central lines, the 10-5mhz probe is fine. We started out with that probe and I struggled to visualize nerves for many months. You can get the blocks done, but you don't feel good about your blocks a lot of them time, unless you have NS backup. Many people say the femoral block is fine with this probe. The 13-6 38mm probe is way better. I could see the nerves after injection quite well once we got this probe. The Sonosite hfl50 is 50mm wide and like 15-8mhz and is even better but we don't have one. All the good YouTube videos use the HFL 50 (on the screen, L50 is the hfl50 and HFL is the hfl38). Sonosite is expensive though.

If your TEE machine has a high freq linear probe, you can use that, but the TTE machines take forever to boot up and need to be plugged in.

Hmm, I never thought of using our TEE machine. I will have to give it a try. I see that you can get a DP-50 probe at 12-8mhz. Hopefully I will get Mindray rep to come in demo the machine, in which case I will have him bring in the higher frequency probe to try out for blocks too.

 

[Oggg]

The mindray website lists M5 M7 and DP-6900.

 

[TheSandMan]

The mindray website lists M5 M7 and DP-6900.

This is the DP-50 I was referring to: http://www.mindray.com/na/products/DP-50.html

I can't find again on their website the info on the probe frequency range, but it is listed on this other website I just found:
http://www.ultrasoundportables.com/by-brand/mindray/mindray-dp-50

I think I remember the rep telling me the DP-6900 was a vastly inferior machine to the newer ones and that he does not recommend them to his buyers. Could be thinking of another machine though

Hopefully I will get to demo a couple of the mindray models soon. I am concerned that until we get a better machine that people will actually use, no-one in the group is familiar enough with ultrasound imaging to determine how good the demo models really are.

 

[Oggg]

Mindray 10L24EA Linear Array transducer (8/10/12 Mhz)

Make sure you demo this probe. It is lower frequency than Sonosites HFL38, and the footprint might only be 24mm by the look of the name. That makes your picture narrower, so you can't see as much. For me that's two strikes. Can you demo the Sonosite the same day or near the same time? I bet Sonosite's image optimization is simpler and better than Mindray's.

 

[Tuohy]

I would NOT buy a Mindray-their service is notoriously poor. In addition, the service is said to be outsourced to a local repair agency (not directly through the company). Lots of extra buttons and dials which are unnecessary for the typical clinician. They also try to upsell you on their upload software/PDF stuff (which is completely unnecessary if you have a thermal printer hooked up to the back of the machine). Go with GE or Sonosite. Trust me-I have purchased 7 machines for my facility.

 

[epidural man]

It has a smaller screen though. If you want a big screen, go with the GE.

Get the ultrasound machine that has that finger probe. That is pretty cool.

 

[TheSandMan]

I would NOT buy a Mindray-their service is notoriously poor. In addition, the service is said to be outsourced to a local repair agency (not directly through the company). Lots of extra buttons and dials which are unnecessary for the typical clinician. They also try to upsell you on their upload software/PDF stuff (which is completely unnecessary if you have a thermal printer hooked up to the back of the machine). Go with GE or Sonosite. Trust me-I have purchased 7 machines for my facility.

Good to know. I was getting the impression that mindrays support may be weak because once the salesman knew that I was not looking for an immediate purchase (which he asked me flat out about), he tried to talk me out of doing a demo. I assume that is because he doesn't see himself long-term with the company. To me, that doesn't really speak well for the company.

 

[Oggg]

We recently got a new m turbo Sonosite. It has MBe needle visualization software, unlike our older m turbo. For most of my blocks it is unnecessary, but it's actually bailed me out of several blocks where the angle was steeper than I anticipated or the pt was deeper than average or the image was fuzzing out. Interestingly, I've been doing some more supraclavicular blocks lately and it seems to be helpful at the corner pocket. Again, not every time, but enough for me to want to always use the new machine with MBe so that if I'm ever struggling with a block I can turn it on.

 

[pjl]

Ordering the s-nerve in a week or so.
Cheaper than m turbo and will keep other specialties grubby hands off of it. Less confusing buttons for our excellent nursing help to deal with

 

[Oggg]

Omfg how many times do I have to tell people (RNs, techs, and my graying partners) where the bloody Save button is?!?!?

Hint, put a big red arrow sticker next to your save button so people can find it fast.