These machines use a clamshell laptop or small television design (Fig.12.3), and newer machines have touchscreen monitors contained in durable plastic housing. They usually have handles that allow the machine to be carried like a briefcase, and some can t into a backpack. These systems may also be mounted on wheeled carts with cups to hold transducers and gel. They have the advantage of being detachable from the cart and carried if eld portability is needed. They usually have one connection port for one transducer to be attached, and do not have the ability to add multiple probes simultaneously unless connected to a multiport adapter. Some companies are exploring Bluetooth cable-free transducers for this level of machine to free users from cable entanglement while changing probes. Hand-carried machines require less storage space than larger cart-based systems, but still require designated housing areas. Many of them can handle advanced applications, but software packages and certain capabilities may not be offered for all machines. They may provide less video output options, and may not pos­sess inbuilt internet solutions like a wi- card, thus requiring external Ethernet adaptors or USB/SD card storage and retrieval. In 2017, these machines typically cost between $20,000 and $50,000 USD depending on the probes, cart, and soft­ware packages purchased with it. They also carry warranties lasting about a 3–5year span.

The newest models employ touchscreens, with other models using Blackberry­like qwerty buttons or dials. “Older” generation machines available in the early 2000s do not have wireless connectivity options and require docking to a computer to transfer images. The latest devices support USB or micro-SD card image stor­age and transfer of images via wireless internet (cloud or email). Some of these machines may not offer video output connection, and, in general, are not designed for intermediate- advanced features. Image quality is not as good as cart-based or hand- carried machines, but as technology advances, this is improving. They are easily storable, but theft may be a problem. They are also prone to issues that affect current tablets: screen glare, difculty obtaining optimum viewing angle, nger­print smudges, freezes or forced reboots, and “buggy” image export. However, interest is increasing as their accessibility, relative low cost, easy storage, and decent image quality caters to populations (primary care, international work, EMS eld use, education, etc.) that have been hindered in the past. As of 2015, these machines typically cost $7500–$15,000 USD. Their warranties last 1–5 years, though shorter warranties are more typical with this type of equipment. As of late 2017, new pocket-size machines based on non-piezoelectric technology called CMUT (capacitive micromachined ultrasound transducer) were announced for shipping in 2018. These machines use silicon chips to create voltage sent across a membrane to generate a sound wave. They have the ability to create a wide beam­width and enable one transducer to perform across a variety of US probe formats, from linear to curved to phased array, which then can be utilized for multiple appli­cations. They use algorithms and signal processing to create optimal images. With the ability to plug into a smartphone, and the advertised price of near $2000, the new CMUT technology may have a large effect on portable US use with POC US, remote, prehospital, and even home use.