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Discover Fully-Synchronized EMG and Neuromuscular Ultrasound
Sierra software integrates electrophysiological data and ultrasound imaging in real-time, aiding in more precise diagnostics.
Experience Our Clearest Ultrasound Imaging
See every detail with greater clarity for improved visualization of muscles, nerves, and surrounding structures.
Explore Advanced Research Features
Sierra software delivers enhanced research features, including the Q-Mode™ research tool and the Sierra Analytics™ results database.
Next Generation Sierra Software
With fully-customizable protocols and an easy-to-use interface, the software is designed to adapt to every clinical workflow. Continuously evolving based on user feedback, Sierra software complements the capabilities of the Sierra Summit® system and Sierra NMUS1® ultrasound, supporting improved efficiency, a streamlined workflow, and enhanced clinical insights.
Beyond Integrated: Fully-Synchronized EMG and Neuromuscular Ultrasound
The latest Sierra software updates brings electrophysiological data and ultrasound imaging together in real-time on a single screen, aiding in needle EMG, chemodenervation, nerve block, and hydrodissection procedures.
The new EMG/US Guidance+ protocol leverages concurrent EMG and ultrasound technology, delivering powerful reporting, needle visualization, and injection tracking tools.
Flexible Electrodiagnostic Testing Features and Advanced Protocols
Sierra software is designed with customizable features that adapt to your needs and the electrodiagnostic studies you perform.
- Tailor Your System to Your Practice: Choose from essential and advanced testing protocols based on the needs your facility, and upgrade as your practice evolves
- Personalized Settings: Customize your experience with user-defined studies, protocols, controls, and settings that can easily be adjusted on the fly
- Simplified Data Acquisition and Analysis: Streamline data acquisition and analysis with test-specific functions and auto-calculation tools that enable you to place measurement markers with a single click
Nerve Conduction Studies (NCS)
Run an entire NCS from the palm of your hand with the StimTroller® Plus handheld stimulator, offering precise control over intensity, pulse width, distance, nerve selection, site selection, trace history, and more.
- Help save time and improve patient comfort with combination tests that allow simultaneous acquisition of motor, sensory, and F-waves, reducing redundancy while maximizing data collection
- Effortlessly add, move, or relabel data
- Edit parameters and set up multiple traces side-by-side or mixed nerve comparisons
- Display the entire examination in a single view with Tab Data Summary and automate findings generation for quick and accurate reporting
Sierra NCS+
Motor + Sensory
Motor + F Wave
CTS Strategy
Trace History and Trials
See the entire stim history at once or one trace at a time. Save multiple trials per site.
Live and Post Hoc Averaging
Average or exclude traces post acquisition using either trace history option.
Visible Reference Limits
Show the reference limits on traces during cursor adjustment or review.
Nerve Conduction Studies (NCS) Test Protocols
- Motor NCS
- Sensory NCS
- Mixed NCS
- Inching
- F-Wave
- H-Reflex
- Repetitive Nerve Stimulation
- Blink Reflex (Electric and Manual Stimulation)
- Silent Period
- Triple Stimulation
- Long Latency Reflex (LLR)
- Near-Nerve Studies
- Motor Unit Number Estimation (MUNE) – Multiple Point Stimulation and Incremental
- Motor Unit Number Index (MUNIX)
- Collision Studies (optional)
Electromyography (EMG)
Sierra software delivers intuitive EMG features designed to help you maximize clinical information and decrease examination time.
- Efficiently transition from standard muscle view to a detailed investigation without adding time or complexity
- Gain, sweep, run/stop, playback, and volume adjustments are within easy reach with the StimTroller® Plus
- Enable hands-free MUP triggering, multi-MUP analysis, turns amplitude analysis, and real-time interference pattern analysis for live, quantified results
Eliminate Audio Feedback During Needle EMG
Auto Mute automatically silences audio feedback when the needle is removed, freeing your hands and simplifying your workflow. Available in both EMG+ and SFEMG+.
Anatomy Navigator
Use Anatomy Navigator to quickly filter muscles, tests, and scanning sites, or auto-populate commonly tested muscles.
Sierra EMG+ AutoMUP
Auto-trigger with MUP analysis isolates and quantifies voluntary and spontaneous action potentials in real-time, with live values highlighted for rapid interpretation.
Single Fiber EMG (SFEMG)
SFEMG+ offers real-time jitter analysis with automatic triggering and peak detection. All live data is saved for quick edits and refined results. Hands-free recording, live analysis, and simple editing tools help improve efficiency and accuracy.
EMG and EMG+ Test Protocols
- Routine EMG
- Triggered EMG
- Single MUP Analysis
- Auto Multi MUP Analysis Recruitment
- Ratio Analysis
- Firing Rate Analysis
- MUP Stability Analysis
- SFEMG Stimulated/Volitional
- Macro EMG
- Multi-Channel EMG (2-12 Channel) Guided
- Injection Protocols
Neuromuscular Ultrasound (NMUS)
Ultrasound is no longer an extra step in your electrodiagnostic workflow. The Sierra NMUS1 ultrasound, fully integrated with Sierra software and the Sierra Summit system, delivers an all-in-one solution that helps to eliminate redundant data entry and device switching, while bringing advanced ultrasound insights into your examination.
Optimize Neuromuscular Imaging with Cutting-Edge Nerve HD
Experience our clearest ultrasound imaging quality to date. Sierra software provides sharper visualization of muscles, nerves, and surrounding structures. Nerve HD and other customizable presets provide optimal visualization of neuromuscular anatomy.
See the difference for yourself.
Patent-Pending Fully-Synchronized EMG and Ultrasound
Streamline workflow efficiency with concurrent display of EMG and ultrasound on a single screen with a synchronized data stream. All new EMG/US Guidance+ protocol is designed to aid chemodenervation procedures by leveraging concurrent EMG and ultrasound technology.
Save Time During Data Collection and Review
Sierra’s NMUS+ protocol offers a familiar workflow for efficient and accurate data collection and reporting. Innovative tools like auto and manual results calculations and customizable tables and annotations allows the clinician to customize results to the patient’s unique anatomy.
Compare Muscle and Nerve Structures in Real-Time
Analyze muscle and nerve structures side-by-side with Dual and Quad Mode, enabling real-time comparison of normal versus abnormal physiology and structural changes over time.
NMUS+ Test Protocols
- B-Mode
- Color Flow Doppler-Mode (CFD), with Pulsed Wave (PW)
- M-Mode
- Q-Mode™ (Cadwell’s patent-pending solution designed to improve tissue quantification)
Evoked Potentials (EP)
Access a full suite of evoked potential tests that can be customized to fit your patient care needs. Complement your EMG and MRI studies with EP protocols designed to detect, confirm, and monitor nervous system function.
- Personalize your view and easily compare data side-by-side with vertical or horizontal split screens
- Access advanced post-processing tools to compare, combine, average, grand average, smooth, and invert trials, gaining deeper insights into the data
- Benefit from a more efficient workflow with customizable cursors and calculations for latency, amplitude, inter-latency, inter-amplitude, percentages, and ratios
- Easily make adjustments to parameters, protocols, and channel counts in real time without disrupting your current workflow
MUNIX+
This protocol combines surface EMG and motor NCS to derive a motor unit number index (MUNIX) of a muscle, which can be used to track disease progression in motor neuron diseases including amyotrophic lateral sclerosis (ALS).
Evoked Potentials (EP) Test Protocols
Auditory Evoked Potentials (AEP)
- AEP
- Middle Latency Response (MLR)
- Vestibular Evoked Myogenic Potential (VEMP)
- Electrocochleography (ECochG)
- P300 (with headphones)
- Bone Transducer
- Insert Earphones
- Condensation, Rarefaction, and Alternating
- Click, Tones, PIP 202 and PIP 212
WAV - Trigger-In / Trigger-Out
Somatosensory Evoked Potentials (SEP)
- SEP
- Dermatomal SEP (dSEP)
- Interleave SEP
- Trigger-In / Trigger-Out
- Advanced stimulation modes
Visual Evoked Potential (VEP)
- Pattern VEP
- Flash ERG (FERG)
- Goggle
- Trigger-In / Trigger-Out
- Selectable Fields, Check Sizes, and Targets
Autonomic Testing
- Heart Rate Variability (R-R Interval)
- Valsalva, Deep Breathing, 30:15
- Sympathetic Skin Response (SSR)
- Galvanic Skin Response (GSR)
MEP+ and Triple Stim
- Integrate with magnetic stimulators for motor evoked potentials
Research Features
Generate retrospective insights with Cadwell’s proprietary research tools, available in Sierra software.
Sierra Analytics
Developed as a companion application to Sierra software, Sierra Analytics™ offers a synchronized results database—DBSync—and other data mining tools for retrospective analysis and research of clinical results.
Sierra API
Sierra software supports real-time data output to third-party applications through an accessible API.
Raw Data Export
Raw data export gives you full access to the data you need.
Partner with Cadwell on research, and take electrodiagnostics beyond what’s possible today.
Q-Mode: Quantitative Tissue Assessment
Cadwell’s proprietary quantitative assessment tool for researching ultrasonic quantification of muscle and nerve tissue. Compare muscle and nerve tissue characteristics with mean echo intensity (EI) and mean echo intensity compensated (EIc) for signal attenuation measurements.
Streamline Your Workflow with Fully Customizable Electrodiagnostic Reports
Sierra software streamlines reviewing and communicating diagnostic results with intuitive, time-saving features tailored for physicians.
- Complete reports from any computer with CadLink® synchronization
- Instantly access test results and waveforms with Tab Data Summary View, completing reports without switching screens
- Automatically generate findings paragraphs with personalized phrasing using Auto-Findings Composer
- Complete reports in your preferred style with customizable templates and selections accessible during patient entry, acquisition, and review
- Easily add waveforms, tables, and NMUS images to reports to clearly communicate findings
- Deliver reports directly to a patient’s EMR as embedded data or an attachment via CadLink with HL7
- Export reports in multiple formats (.PDF, .DOCX, or .RTF), or save them to a remote server for easy access and secure storage
CadLink: Secure Data Management
Download materials, get software updates, and request hardware and software features
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Explore Cadwell EDX products
The Sierra® family of products are the ideal solution for Chemodenervation, EMG, EPs, NCS, Ultrasound, and Electrodiagnostics in Urology.
Request an EMG, NCS, EP, and Ultrasound Demonstration
Product availability may vary between different countries and markets.
Please contact Cadwell for additional information.