Comparison of Six Handheld Ultrasound Devices by Pediatric Point of Care Ultrasound (POCUS) Experts

Point of care ultrasound (POCUS) use is increasing among pediatric clinicians, but lack of access to ultrasound devices is a major barrier. The availability of pocket-sized handheld ultrasound devices ("handhelds") has improved access. However, no head-to-head comparative studies of handhelds in children have been performed to guide purchasing decisions.

This cross-sectional study compared six handhelds: Butterfly iQ+™ (Butterfly Network Inc.), Clarius® (Clarius Mobile Health™), Kosmos™(EchoNous), TE Air™ (Mindray®), Vscan Air™ SL (General Electric), and Lumify™ (Philips Healthcare). Eight pediatric POCUS experts acquired views showing the abdominal right upper quadrant (RUQ), cardiac apical 4-chamber, and superficial neck and lung on a standardized pediatric model using each handheld. Experts rated each handheld by its image quality, ease of use, and their overall satisfaction.

Vscan Air™, Kosmos™, and Lumify™ were rated highest for ease of use, image quality, and overall satisfaction. Most experts recommended Vscan Air™ for purchase. The five most desirable characteristics of handhelds were image quality, ease of use, total costs, transducer size, and availability of different transducer types. All six handhelds had important advantages and disadvantages per experts, and no single device had all the desired characteristics.

Pediatric POCUS experts rated Vscan Air™, Kosmos™, and Lumify™ highest for ease of use, image quality, and overall satisfaction. No device was clearly superior across all applications. Subjective characteristics, particularly probe ergonomics, may be a deciding factor when selecting handhelds in pediatrics. There is a need to develop handhelds specifically for use in pediatric populations.