Zebra medical newsletter February 2026
Dearest Zebra Medical Community,
Using the Butterfly iQ+ at the bedside has completely changed the way healthcare professionals approach lung assessment. Instead of waiting for a chest X-ray, they can immediately scan the anterior and lateral chest and look for B-lines – those bright, vertical streaks that arise from the pleura and run to the bottom of the screen. When they see multiple bilateral B-lines in a diffuse pattern, it strongly points towards pulmonary oedema and fluid overload. When they’re focal, they start considering pneumonia, contusion, or other localized lung pathology. One can also assess pleural sliding to help exclude pneumothorax and look for consolidations or effusions that might explain a patient’s symptoms. Having this level of real-time insight at the bedside makes assessments faster, more confident, and far more clinically actionable.
I saw firsthand how powerful this can be when my mother was taken to the ED. The doctor performed a quick ultrasound at the bedside and immediately identified fluid in her lungs by visualising multiple B-lines. At first, he suspected cardiac failure, but after scanning her heart as well, he was able to determine that her heart function was preserved and that she was fluid overloaded due to kidney damage, not heart failure. Because of this rapid, focused assessment, he was able to act quickly and make informed decisions without delays, ensuring she received the appropriate treatment right away.
What stood out most was the reassurance it gave us as a family. Instead of waiting anxiously for test results, we could see the images in real time while the doctor explained what he was seeing and how it guided his thinking. It created immediate clarity, reduced uncertainty, and built trust in the care she was receiving. That level of transparency and speed not only improved clinical decision-making but also significantly enhanced patient and family satisfaction during a very stressful moment.
Butterfly iQ+ Handheld Ultrasound: Redefining Care, Anywhere
Why have I chosen handheld devices like the iQ+ for the past three years?
It allows access without barriers – we have imaging at the bedside, in hospitals or rural clinics, driving to another facility to assess a referral, at the roadside or even in disaster zones. We get rapid answers. FAST exams, cardiac checks, obstetric scans—all in minutes. And best of all? It is at a lower cost than cart-based systems, enabling widespread adoption and training.
I need to make special mention of our increased use of PoCUS to make smarter fluid decisions. There is a growing body of evidence showing that fluid management is critical—and handheld PoCUS makes it smarter. In critical care, handheld POCUS shines in fluid assessment and responsiveness testing. By integrating the VEXUS score (IVC, hepatic, portal, and renal vein Doppler), we can balance resuscitation with the risk of congestion—guiding nuanced decisions. This is lifesaving in septic shock, trauma resuscitation, and daily ICU care. We as clinicians can assess venous congestion and fluid responsiveness in real time. This means safer resuscitation, fewer complications, and better patient outcomes—all without the immediate need of invasive monitoring.
Recently I also stumbled upon the potential of “innovative medicine” through access to 3D Printing. Handheld probes become even more versatile with custom 3D-printed accessories.
We have designed and tried out a few prototypes for the following uses:
- Mounting clips for hands-free imaging
- Anatomical markers and holders for vascular access
- Training phantoms for teaching VEXUS and vascular skills
These locally manufactured solutions have the potential to reduce costs, empower clinicians, and extend device utility in challenging environments.
The Bottom Line
Over the time I have been fortunate enough to have access to a Butterfly iQ+ handheld ultrasound I have come to realise that it is more than portable imaging—it’s a catalyst for equity.
By integrating advanced applications such as the VEXUS score for fluid assessment, and by harnessing 3D printing for practical accessories, handheld ultrasound devices can transform emergency and critical care in resourceconstrained systems. The future of POCUS lies not only in the technology itself, but in the partnerships between clinicians, innovators, and companies committed to making lifesaving imaging accessible to all.
by Dr Dawie Schoeman
Specialist Emergency Physician, Critical Care / ICU Livingstone Tertiary Hospital
Right Pleural Effusion | Clinical Image
TESTIMONIAL
“The Butterfly iQ+ has had a profound impact on my clinical practice.
As a specialist physician and pulmonologist who practices in a setting with a high HIV/TB burden, through this device one has been able to make diagnostic and therapeutic interventions pertaining to diseases of the thorax such as transthoracic diagnostic and biopsy of lung masses, diagnostic and drainage of pleural effusions, diagnosis of disseminated TB and DVT just to name a few.
This device has endless potential not only for improved and efficient patient care, but also for the upskilling of medical professionals who are in various stages of their development.”
– Dr Ayanda Trevor Mnguni
Head of Department: Internal Medicine: Khayelitsha District Hospital
Consultant: Internal Medicine, Tygerberg Hospital & Stellenbosch University Specialist Physician and Pulmonologist
Senior Lecturer: Stellenbosch University
