I’ve been trialing a Butterfly iQ+ for 2-minute preop gastric and IVC scans on ASA III–IV or high STOP-Bang patients, and it’s changed how we stratify aspiration risk and anticipate hemodynamics before induction. For those using handhelds in a crowded preop bay, which presets and probe placements give you the most reliable reads, and have you seen tangible safety gains like fewer rapid-sequence surprises or post-induction hypotension?
I’ve had good luck on the iQ+ using Abdomen/Gallbladder for gastric at about 10–12 cm in RLD — park sagittal just right of midline and “follow the liver to the antrum” to avoid mistaking fundus/air. For IVC I flip to Cardiac, subxiphoid long-axis, measure about 2 cm below the hepatic vein confluence with a gentle M‑mode sniff, but I treat collapsibility warily in morbid obesity or AF and sometimes cross-check IJ variability. Tangible win: caught two “full stomachs” pre-induction and changed plans — like spotting the Lego before the 5 a.m. barefoot walk.