Handheld ultrasound for emergency medicine, window by window

For a department that wants one device, the Suresult D3Ultra is the strongest fit because it carries convex, linear and phased heads in a single probe. When echo and vascular lines dominate the shift, the CD2 pairs a phased head with a linear head across 192 elements at 150 g. When procedures come first, the L10T adds bi-plane needle guidance.

A handheld ultrasound can perform a FAST exam when it carries a convex or phased head with enough depth for the subcostal, flank and suprapubic windows. The Suresult D3Ultra reaches 300 mm on its convex head, and Suresult buyers captured the subcostal liver and suprapubic windows on that model.

A phased head is needed for the parasternal and apical cardiac windows, which are imaged between the ribs. A convex head reaches the subcostal window, the IVC and the abdominal aorta. The Suresult D3 family carries both formats in one probe.

The Suresult D3Ultra convex head reaches 300 mm, and the D3Pro and D3L reach 305 mm. A D3Ultra epigastric capture recorded at 240 mm of depth carries on-screen labels for the aorta and the vena cava.

The Suresult D3Ultra is $2,976, the CD2 is $2,697 and the L10T is $2,418, with the software included in each price. Competing handhelds list at $3,899 for the Butterfly iQ3, $4,999 for the GE Vscan Air CL and $5,395 for the Clarius PAL HD3, before any membership fee.

Suresult charges no subscription for its handheld ultrasound software. Color Doppler, pulsed-wave Doppler, power Doppler, M-mode, measurements, needle guides and DICOM export are included with every Suresult scanner on this page. Clarius lists an Essentials membership at $695 per year and Butterfly lists $299 to $420 per year.

A handheld covers focused emergency questions: free fluid, lung water, pericardial effusion, aortic diameter, hydronephrosis and vascular access. A full quantitative echocardiogram, formal obstetric biometry or a transesophageal study stays on a cart system.

The L10T is the model built for it, because two linear arrays at right angles across 192 elements show the needle in-plane and out-of-plane at the same time. The CD2 linear head and the D3Ultra linear head also carry in-plane and out-of-plane needle guides.

A handheld ultrasound shows lung B-lines and pleural sliding from an anterior chest window. A Suresult buyer submitted a D3Ultra cine loop of diffuse B-lines in acute pulmonary edema, and a Suresult demonstration video runs a nine-minute lung sweep zone by zone. Pivetta and colleagues found lung ultrasound added to the clinical exam reached 97% sensitivity for acute decompensated heart failure in 1,005 emergency patients.

The Suresult app includes calipers, cine loops of 100 to 1,000 frames and export as DICOM, JPEG, PNG or MP4. A D3Ultra suprapubic capture carries two buyer measurements on screen, 33.37 mm and 43.62 mm.

Suresult software runs on iOS, Android and Windows. The D3Ultra connects over dual-band 802.11n Wi-Fi, and the CD2 and PD1 add a cable connection.

Smith-Bindman and colleagues randomized 2,759 emergency patients with suspected nephrolithiasis to point-of-care ultrasound, radiology ultrasound or CT. High-risk diagnoses with complications occurred in 0.4% and did not vary by imaging method, and six-month radiation exposure was lower in both ultrasound groups.

A handheld ultrasound can guide nerve blocks in the emergency department. The linear head with an in-plane needle guide covers the blocks used for hip fracture and limb injury. One buyer submitted D3Ultra captures of twelve block types and said he uses the hardware for prehospital emergency medicine.

Rubano and colleagues pooled seven studies covering 655 patients and found emergency department bedside ultrasound had 99% sensitivity and 98% specificity for abdominal aortic aneurysm. The epigastric transverse window is the view that measurement comes from.