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Part of Pediatric Distal Forearm Fractures
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Butterfly iQ+ Ultrasound

Any ultrasound device with a linear transducer (from 3.5 to 16 MHz and more) is suitable for fracture sonography.[1] Nearly almost all commercially available portable ultrasound devices can be used.[2][3][4][5]

The Butterfly iQ is the world's first handheld, single-probe whole-body ultrasound system using proprietary semiconductor technology.[6] The iQ’s diagnostic power, portability, durability, ease-of-use, and offline access for extended periods advances fracture diagnosis and care in resource-constrained environments.[7]

The Butterfly iQ+ probe extends scanning time by 100%, is powered by a rechargeable battery with an extended battery life of 144 minutes of continuous scanning, and is built to last a traditional shift of 10-12 hours with intermittent scanning.[8][9]

The iQ+ probe is connected with a cable to a mobile device with the Butterfly iQ app.[10] The iQ+ must be cleaned and disinfected after use.

The iQ+ offers military-grade durability and has been tested to withstand an industry-leading 4-foot drop.[11] The device has a durable, anodized aluminum body and a replaceable compression- and stomp-tested cable. The iQ+ has undergone rigorous testing to ensure shock resistance and protection from dust and water damage.

The operating temperature of the iQ+ is between 5°C to 39°C.[10] The probe can withstand three days of storage at temperatures between -20°C and 50°C.

To withstand rough handling during transport, the iQ+ is stored inside a hard case with a tough polycarbonate exterior and soft, protective thermoplastic elastomer interior.[12]

Butterfly iQ+ System Components[edit | edit source]

  • Butterfly iQ+ Probe[13]
  • Charging Base
  • Power Supply, and 4 Regional Adaptors (US, EU, UK, AU)
  • Android or iOS Mobile Device Compatible with Butterfly iQ+[14][15]
  • Cable (compatible with the mobile device)
  • Butterfly App (available in Google Play Store and Apple App Store)
  • Butterfly Hard Case[16]
  • User Manual[17]
  • Ultrasound Gel
  • Compatible Cleaning and Disinfection Products[18]
  • Optional: Ruggedized Mobile Device Case and Tablet Mount or Stand[19][20]

According to the manufacturer, practitioners with "tenuous or intermittent lack of Wi-Fi may choose a tablet with LTE connection such that the images they collect can be transferred to the cloud over the LTE network and not stored locally on the device (which has robust-but-limited storage)."[21]

Benefits of the Butterfly iQ+ for LMICs[edit | edit source]

  • Affordability ($2,399 USD)[22]
  • Global Health Program members will be able to purchase Butterfly iQ devices with discounted annual subscription fees[23]
  • In 2020, Funding from Humanitarian Grand Challenges was provided to Bridge to Health Medical and Dental USA & MedGlobal to train local healthcare providers to use the Butterfly iQ device in Yemen[24]
  • In 2022, $5 million USD in funding from the Bill and Melinda Gates Foundation was awarded to provide Butterfly iQ devices to 1,000 healthcare workers in Sub-Saharan Africa[25][26]

Procurement and Set-Up[edit | edit source]

The Butterfly iQ+ can only be purchased by and shipped directly to a licensed practitioner in countries where regulatory approval has been obtained. These countries include: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, Italy, the Netherlands, New Zealand, Norway, Poland, Portugal, Spain, Sweden, Switzerland, the United Kingdom, and the United States.[27] The Butterfly iQ+ System can be either hand carried or shipped to other countries for clinical education use only.

OOjs UI icon notice-destructive.svg

The Butterfly App would need to be downloaded on the mobile device on which the Butterfly iQ+ would be used in the country where it was sold prior to arrival in a LMIC.

Regulatory Approval[edit | edit source]

We have already started investigating how to obtain regulatory clearance of the Butterfly iQ+ in Nigeria, and if time and resources permit after the Finalist Award phase, we would pursue regulatory clearance in Nigeria so licensed practitioners across the country would be able to purchase this device directly. If permitted, we would openly share our regulatory clearance documents with other LMICs to help scale up global access to the Butterfly iQ+.

If you wish to use a portable ultrasound device that already has regulatory approval in your region, the EchoNous Kosmos platform (~$8,500 to $12,500 USD) has regulatory clearance in the following 125 countries listed below:[28]

Europe

  1. Austria
  2. Belgium
  3. Cyprus
  4. Denmark
  5. Finland
  6. France
  7. Germany
  8. Greece
  9. Iceland
  10. Ireland
  11. Italy
  12. Luxembourg
  13. Malta
  14. Netherlands
  15. Northern Ireland
  16. Norway
  17. Portugal
  18. Spain
  19. Sweden
  20. Switzerland
  21. United Kingdom

Eastern Europe

  1. Albania
  2. Belarus
  3. Bosnia Herzegovina
  4. Bulgaria
  5. Croatia
  6. Czech Republic
  7. Estonia
  8. Hungary
  9. Kosovo
  10. Latvia
  11. Lithuania
  12. Moldova
  13. Montenegro
  14. North Macedonia
  15. Poland
  16. Romania
  17. Russia
  18. Serbia
  19. Slovakia
  20. Slovenia
  21. Turkey
  22. Ukraine

Middle East

  1. Bahrain
  2. Egypt
  3. Iran
  4. Iraq
  5. Israel
  6. Jordan
  7. Kuwait
  8. Lebanon
  9. Libya
  10. Oman
  11. Palestine
  12. Qatar
  13. Saudi Arabia
  14. Syria
  15. United Arab Emirates
  16. Yemen

Africa

  1. Algeria
  2. Angola
  3. Cameroon
  4. Gambia
  5. Ghana
  6. Guinea
  7. Kenya
  8. Liberia
  9. Morocco
  10. Mozambique
  11. Namibia
  12. Nigeria
  13. Rwanda
  14. South Africa
  15. Tanzania
  16. Tunisia
  17. Uganda
  18. Zambia
  19. Zimbabwe

Asia

  1. Japan
  2. Australia
  3. Bangladesh
  4. Brunei
  5. Cambodia
  6. China
  7. Fiji
  8. Hong Kong
  9. India
  10. Indonesia
  11. Laos
  12. Malaysia
  13. Myanmar
  14. Nepal
  15. New Zealand
  16. Pakistan
  17. Papua New Guinea
  18. Philippines
  19. Singapore
  20. South Korea
  21. Sri Lanka
  22. Tawain
  23. Thailand
  24. Vietnam

South America

  1. Argentina
  2. Bolivia
  3. Brazil
  4. Chile
  5. Colombia
  6. Costa Rica
  7. Cuba
  8. Dominican Republic
  9. Ecuador
  10. El Salvador
  11. Guadeloupe
  12. Guatemala
  13. Haiti
  14. Honuras
  15. Martinque
  16. Mexico
  17. Nicaragua
  18. Panama
  19. Paraguay
  20. Peru
  21. Puerto Rico
  22. Uruguay
  23. Venezuela

Acknowledgements[edit | edit source]

This work is funded by a grant from the Intuitive Foundation. Any research, findings, conclusions, or recommendations expressed in this work are those of the author(s), and not of the Intuitive Foundation.

References[edit | edit source]

  1. Ackermann O. Fracture sonography: a comprehensive clinical guide. Cham (Switzerland): Springer Nature Switzerland AG; 2019, 2021. 163 p.
  2. https://handheldultrasound.gehealthcare.com/
  3. https://vscan.rocks/product
  4. https://kosmosplatform.com/
  5. https://www.sonosite.com/products/sonosite-m-turbo
  6. https://www.butterflynetwork.com/iq
  7. https://www.butterflynetwork.com/global-health
  8. Jody McDonald, RVT; Inside Sales - Clinical Expert Consultant; Butterfly Network, Inc. Personal Communication. January 25, 2022.
  9. https://support.butterflynetwork.com/hc/en-us/articles/360030750152-Use-Without-Internet
  10. 10.0 10.1 Butterfly Network, Inc. Butterfly iQ™/Butterfly iQ+™ Personal Ultrasound System - User Manual [Internet]. Butterfly iQ+. Butterfly Network, Inc.; 2020 [cited 2022 Feb 1]. Available from: https://manual.butterflynetwork.com/butterfly-iq-user-manual_rev-ac-en.pdf.
  11. Butterfly Network Reinvents Ultrasound Again With New Butterfly iQ+ [Internet]. Matamoros, TA: Butterfly iQ+; 2020 [cited 2022 Feb 1]. Available from: https://www.butterflynetwork.com/press-releases/butterfly-iq-pluss-press-release.  
  12. Butterfly Network, Inc. Butterfly Hard Case [Internet]. Butterfly Network, Inc; 2022 [cited 2022 Feb 1]. Available from: https://store.butterflynetwork.com/us/en/product/butterfly-hard-case/.
  13. https://store.butterflynetwork.com/ca/en/product/butterfly-iq/pro/1-year/
  14. https://support.butterflynetwork.com/hc/en-us/articles/360028326031-Compatible-Devices
  15. https://www.apple.com/ca/ipad-10.2/
  16. https://store.butterflynetwork.com/us/en/product/butterfly-hard-case/
  17. https://support.butterflynetwork.com/hc/en-us/articles/360019540192-User-Manual
  18. https://support.butterflynetwork.com/hc/en-us/articles/360040976672-Compatible-Cleaning-and-Disinfection-Products
  19. https://support.butterflynetwork.com/hc/en-us/articles/360049651351-Third-Party-Accessories
  20. https://www.apple.com/ca/shop/product/HNTE2ZM/A/otterbox-symmetry-series-360-case-for-ipad-7th-8th-generation
  21. Dr. David Walton, Senior Director of Global Health, Butterfly Network, Inc. Personal communication. July 24, 2022.
  22. https://store.butterflynetwork.com/us/en/product-flow/step-1
  23. https://www.butterflynetwork.com/our-mission#globalhealthform
  24. https://humanitariangrandchallenge.org/innovator/bridge-to-health-usa/
  25. https://www.gatesfoundation.org/about/committed-grants/2022/03/inv040773
  26. https://ir.butterflynetwork.com/news/news-details/2022/Butterfly-Network-Receives-5M-Grant-to-Advance-Maternal-and-Fetal-Health/default.aspx
  27. https://support.butterflynetwork.com/hc/en-us/articles/360031231172-Who-Can-Purchase-Butterfly-iQ-
  28. Annmarie Lobdell, MHS, RDMS, RDCS, RVT; East Region - Inside Sales Representative; EchoNous Kosmos. Personal Communication. February 24, 2022.
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