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COVID-19: Has lung ultrasound become the new standard of care?

December 15, 2020 5:00pm EST / 2:00pm PST

As COVID-19 continues to spread rapidly, join us and a panel of experts as we come together to discuss the role that lung ultrasound is playing. Publications show POCUS to be affordable, easily deployable, and clinically impactful* in support of the frontline in their care delivery.

Webinar Zoom Link

At this webinar, we will cover the following:

  • Dr. Jennifer Peña will recap the current state of COVID-19 in the USA.
  • Dr. Emanuele Pivetta will review his experience with lung ultrasound and his recent publication, Lung ultrasound for the diagnosis of SARS-CoV-2 pneumonia in the Emergency Department.
  • Dr. Ryan Gibbons will review his lung ultrasound use model and his recent publication comparing it to chest radiography.
  • Dr. Nahreen Ahmed and Dr. Mike Stone will have a live education session on typical lung ultrasound findings in COVID-19. Please share images for review at imagereview@butterflynetwork.com
  • Use Cases: Dr. Joseph Nunan from the Royal Berkshire Hospital UK will walk through their successful deployment model of LUS in NHS triage clinics.
  • Use Case: Dr. Daniel Durand from LifeBridge Health USA will review how POCUS was quickly deployed into multiple departments.
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Moderators

Dr. John Martin

Chief Medical Officer,
Butterfly Network Inc.

Dr. Mike Stone

VP of Education and Sonography,
Butterfly Network Inc.

Panelists

Dr. Jennifer Peña

Hospitalist at INOVA. Medical Director for Global Executive Medicine. Former Primary Care Physician to the Vice President of the United States.

Dr. Emanuele Pivetta, MD, MSc, PhD

Division of Emergency Medicine and High Dependency Unit. Department of General and Specialized Medicine. AOU Città della Salute e della Scienza di Torino - Molinette Hospital.

Dr. Daniel Durand (USA) LifeBridge

Chairman of Radiology, 
Lifebridge Health.

Dr. Ryan C. Gibbons, MD, FAAEM, FACEP

Assistant Director, Division of Emergency Ultrasound. Assistant Professor, Department of Emergency Medicine. Director, Ultrasound in Medical Education. Lewis Katz School of Medicine at Temple University.

Dr. Nahreen H. Ahmed

Assistant Professor of Clinical Medicine Division of Pulmonary & Critical Care University of Pennsylvania

Dr. Joseph Nunan

Ultrasound Fellow, Acute Medical Unit,
Royal Berkshire Hospital.

Publications

What we’ve learned.

Evidence supporting the use of lung ultrasound in COVID-19 healthcare delivery.

Multi-organ POCUS for COVID-19: International Expert Consensus

This consensus document based on the available evidence and expert opinion encourage the use of PoCUS to support improved patient outcomes during the current pandemic, and the development of meaningful protocols and practices to overcome COVID-19 and prepare for future challenges.

Read article
Western Journal of Emergency Medicine

Point-of-care lung ultrasound is more sensitive than CXR for evaluation of COVID-19.

Read article
Self-Performed Lung Ultrasound for Home Monitoring of COVID-19

This report details the integration of Lung Ultrasound into the home treatment plan of an HCP with COVID-19, using a novel Teleguidance approach

Read article
Acute Medicine

Encouraging evidence exploring the utility of point-of-care ultrasound to predict a range of adverse outcomes in patients with suspected COVID-19.

Read article
Annals of Emergency Medicine

POCUS can improve diagnostic sensitivity for COVID-19 pneumonia, in conjunction with PCR and clinical assessment.

Read article
Review all publications
COVID-19 patient management

POCUS for patient management across the care continuum.

In 2020 we have learned that there are a number of possible situations where handheld whole-body ultrasound plays a valuable role. Bedside ultrasound has been shown to have a valuable cross-specialty role in informing decisions around COVID-19 across the full spectrum of clinical management.

Emergency medicine

POCUS is an initial imaging modality for patients presenting to the Emergency Department suspected of COVID-19 infection and pulmonary involvement. This reduces dependencies on CT and CXR, and can impact the ability to risk stratify while maintaining isolation protocols.

Primary care

Handheld ultrasound setting can be utilized by HCPs in primary care, urgent care, skilled nursing, and home healthcare settings to help decrease the need for patient transport for advanced imaging.

Critical care

With POCUS, the monitoring of hospitalized patients, particularly in high dependency units such as the ICU, can be done at the bedside.  A dedicated handheld ultrasound system can remain with the patient throughout their hospital stay, eliminating the risk of patient-to-patient nosocomial transmission via ultrasound systems. Lung imaging findings have also been shown to support decisions about disease severity, and can help support critical care decisions such as ventilator allocation.

Telemedicine

Systematic integration of portable ultrasound imaging in the community, leveraging telemedicine guidance when necessary, could facilitate early detection of imaging features typical of COVID-19. This has the potential to inform clinicians’ decisions around isolation and quarantine of early or asymptomatic cases. Telemedicine also has the ability to support remote clinician exams to keep healthy patients, such as those requiring routine prenatal monitoring, from entering a potentially infected facility or space. Read more here.

What is the return policy?

We offer a 14-day money back guarantee. If you reach out to us and request a return within 14 days of delivery, we can accept your return and refund the full purchase. For more information on our 14-day money back guarantee, click here.

Learn how to deploy POCUS into your frontline healthcare delivery.

View triage workflow
Education

Learn lung ultrasound.

The Butterfly Education platform provides a diverse video library of instructional content to support our frontline COVID-19 care providers.

Lung ultrasound in COVID-19.

Learn how to perform and interpret lung ultrasound in COVID-19.

Take free course

Basic scanning technique

Learn the basic technique on how to evaluate the lung surface for sliding and artifacts using your Butterfly iQ.

Lung Protocol

Comprehensive lung exams assisted by real-time segment-by-segment guidance has been built to help increase rapidity of frontline patient assessment, and potentially reduce viral exposure. Available to Pro and Enterprise members.

See more videosGet a demo

COVID-19 webinars

COVID-19: Has lung ultrasound become the new standard of care?

In December, Butterfly hosted a webinar with a panel of experts to discuss the role that lung ultrasound is playing in the fight against COVID-19.

See all webinars
Safety

Cleaning and disinfecting.

How to use a standard sheath to cover a Butterfly iQ and a phone.

This and other videos are offered for demonstration only—always follow your institutions’ protocols for proper use of PPE and cleaning and disinfection protocols.

Review disinfection guide

Stay updated.

A network of like-minded clinicians sharing new evidence, educational materials, clinical imagery and best practices, periodically, direct to your inbox.

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Frequently asked questions.

Can lung ultrasound be used to diagnose COVID-19?

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.

Why would I use lung ultrasound in a patient with suspected COVID-19?

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.

Why would I use lung ultrasound in a patient with confirmed COVID-19?

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.

What are some of the lung ultrasound features of COVID-19?

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

How could I use ultrasound to monitor a patient with confirmed COVID-19?

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.

How should I disinfect my ultrasound probe?

We’ve expanded our list of chemically compatible cleaners and disinfectants for the iQ with 63 additional products. Clinicians may consider the use of a sterile probe sheath as an additional barrier precaution. View a demonstration video at the link: Compatible cleaners and disinfectants for COVID-19

Do the probe and phone still work when contained within a sheath? If so do you have recommendations as to which sheath should we use?

Many users have reported positive results placing both Butterfly 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.

I want to help! What can I do?

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 covid@butterflynetwork.com for more details.

I want to contribute images! How can I do that?

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 covid@butterflynetwork.com, and we will be happy to provide further instructions. We appreciate your contributions to this evolving resource center.