Air Rescue Africa makes use of the Butterfly IQ+ as part of the standard equipment on all air ambulance missions. We have been using point of care ultrasound in the air for the past 10 years, but since introducing the Butterfly IQ+ at end of 2022 it has made a tangible impact on patient care and clinical governance. The ease of use, compact size and versatility makes it the ideal portable device for air ambulance operations. Reviewing scans done by our clinicians are now easier than ever and has contributed significantly to strengthening our governance of ultrasound use. We’ve had many instances where the devices assisted us in making a diagnosis or performing procedures in resource limited settings all across the African continent. Good examples being patients receiving ultrasound guided regional Anaesthesia for various limb injuries, in many cases then being transported pain free.

At the University of Pretoria, we have successfully implemented ultrasound training into our 5th year medical programme. Making use the extensive library of training videos with self -assesement we designed a compulsory pre-practical platform which each student had to pass and provide a completeion certificate. Thereafter, they were issued with Butterfly Ultrasoundprobes and allowed to practice eFast's on ward patient, under supervision. The final step was a live one-on-one patient US assessment which was graded.
This year, all 278 students were passed as proficient in basic ultrasound. Next year we look forward to integrating the new AI Butterfly software into practical component, allowing for greater exposure to live patients without requiring more supervision. In addition, we have now implemented a compulsory ultrasound training module for our general surgery registars, and in-between training are able to use the probes to perform bedside procedures such as placing CVP's, draining absecesses etc. Awesome product and platform, well done Zebra Medical for bringing it to SA!!

I’ve been using the ButterflyiQ+™ ultrasound device for a while now when I’m doing my clinical shifts. The biggest value for me is that the device is ultra-mobile, allowing me to quickly move between patients without the hassle of playing ‘musical beds’ with patients in an overcrowded emergency centre where it’s difficult to manoeuvre the big cart-based machines next to the patient. The Butterfly iQ+™ device also allows me to use different frequencies to assess various parts of the body without the need to change probes. It’s a single probe for whole body use.
On one of my recent shifts, I evaluated a 36-year-old female with a very atypical presentation of loss of vision, weight loss and a painful distended abdomen. She was HIV-positive and had stopped taking her antiretroviral medication. On examination, she had complete vision loss with multiple cranial nerve fallouts, but no meningism. Her left breast had a hard palpable mass. Her abdomen was soft and diffusely tender without signs of peritonism. On point of care ultrasound, she had bilateral pleural effusions, multiple lesions in her liver and spleen, and enlarged para-aortic lymph nodes. The clinical suspicion of breast cancer with metastases was confirmed with histology and a subsequent CT of the brain, chest and abdomen. The ultrasound images assisted in fast tracking the patient to appropriate definitive diagnostic imaging.

I’ve been using the ButterflyiQ+ for over 3 years now and found it to be an invaluable assess to my toolkit as a specialist emergency physician. Although I have access to full stack echocardiography machine, for Quick Look scans, mass casualty incidents, ward rounds and bedside teaching are uniquely suited to Butterfly. I recently published a paper evaluating the utility of this handheld device for the diagnosis of acute valve emergencies (compared against cart based machines) and found surprisingly accurate results.
The smaller footprint of the Butterfly probe compared to the standard linear probe, makes it ideal for procedural guidenace - like difficult peripheral venous access, pericardiocentesis and regional nerve blocks. Although I haven’t found much clinical use for the biplane or pulsed wave features in practice, I use these a lot for bedside teaching. The ability to change to iPad and iPhone as well as stream the output to another device is key feature improving the teaching of pocus.
While the ButterflyiQ+ does not replace my full stack echocardiography capabale machine, it my device of choice for outreach visits, and ward consults, rapid triage (like in mass casualies), on the road and prehospital, and procedural guideance in difficult areas. The ability to offer three probes in one, and its extended battery life with educational support sets it apart from other handheld devices on the market.