Butterfly is hosting a series of sessions for doctors and other health care professionals to learn more about the use of POCUS.
Compare images between a normal lung and those from suspected or confirmed COVID-19 cases.Learn more
Review publications written about lung ultrasound for COVID-19 patients.Review now
A series of global protocols, guidelines and quick guides submitted by practitioners on the COVID-19 front lines.Learn more
Learn how to use the Butterfly iQ to perform lung ultrasound using our library of educational videos.See videos
Review the list of cleaners and disinfectants for your iQ along with a short video demonstrating how to cover your iQ and phone.See the list
Learn how lung ultrasound plays a valuable role for COVID-19 patient management in multiple specialties.Learn more
Butterfly is hosting a series of webinars for doctors and other health care professionals to learn more about the use of POCUS.View now
Hear from clinicians around the world at the front lines of the COVID-19 pandemic.View now
These answers are provided by clinical experts, but should not be interpreted as comprehensive. Patients should always be assessed with their full clinical history in mind and are at the discretion of the individual physician.
Lung ultrasound is used to identify pulmonary complications in suspected and/or confirmed COVID-19 patients and helps risk stratify those for admission and closer observation. It is not diagnostic of COVID-19. The definitive diagnosis is made by real-time RT-polymerase chain reaction (rRT-PCR) detection of the SARS-CoV-2 virus (the virus that causes COVID-19) in respiratory specimens.
Lung ultrasound is a portable, bedside, radiation-free, inexpensive imaging modality that can readily detect many features of COVID-19 associated lung disease. The cost, portability, accuracy and ability to use in an isolated environment lead to significant potential benefit over chest radiography or computed tomography (CT) imaging. Imaging findings can accelerate disposition decisions while awaiting culture results.
Clinicians are using lung ultrasound to assess and monitor COVID-19 patients with hypoxemia and to assess high risk infected patients to stratify disposition decisions. Lung ultrasound findings can change dynamically through the course of an illness, and monitoring for progression of B-lines and/or consolidation (or for resolution with return of a normal A-line pattern) could provide valuable information to the treatment team. While CT has confirmed value in the evaluation of COVID-19, many patients are too ill to transport or can extend the exposure risk to more health care providers. CT is also more expensive and studies suggest ultrasound may be equally as informative.
The following ultrasound features have been described in patients with COVID-19 infection:
· A fragmented, irregular pleural line
· B-lines (focal, scattered and/or confluent)
· Bilateral involvement
· Posterior and lateral segment involvement
· Lung consolidation (ranging from small to lobar, with or without air bronchograms)
· Rare pleural effusions
· See this study and this study for further details
Dr. Mike Stone, emergency room physician and Director of Education at Butterfly Network, has put together a proposed protocol based on expert input. Please note that this protocol is not validated by prospective trials. Other clinicians have also shared their protocols with us. View them here:
Serial examinations with lung POCUS can reveal worsening B-lines and/or consolidations, indicating progression of disease. Additionally, return of a normal A-line pattern may indicate signs of recovery. Multiple approaches have been described (6-,8-,12-, 14+ zone protocols) for lung evaluation with POCUS. You may also consider imaging the heart as a baseline measure of ejection fraction. This may be specifically relevant to intensivists caring for severely ill patients with COVID-19.
Many users have reported positive results placing both iQ and mobile device in a standard probe sheath. CIVCO has created a unique landing page for sheaths that will work with the iQ. You may also use standard sheaths available from ProTek, Medline, Sheathes and other retailers. For more details, view our COVID-19 cleaning and disinfection page.
We are actively seeking to connect with the medical community, and add to the data available for research, teaching and understanding of COVID-19. Qualified professionals are encouraged to contribute to our library of de-identified positive cases, as well as share care delivery protocols. Contact us at firstname.lastname@example.org for more details.
The images and clips in our COVID-19 gallery originate from clinicians across the world and have been useful to accelerate learning and collaboration throughout our community. Please reach out to us via email at email@example.com, and we will be happy to provide further instructions. We appreciate your contributions to this evolving resource center.
We are working behind the scenes to help support front-line clinicians on managing patients with confirmed or suspected COVID-19. Join our community that is working together to share de-identified images of positive cases, care delivery protocols and other creative ideas to manage this public health pandemic.Contact us