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New in Sierra 4.1
Sierra Software for Electrodiagnostics

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
Sierra Software for Electrodiagnostics

Experience Our Clearest Ultrasound Imaging

See every detail with greater clarity for improved visualization of muscles, nerves, and surrounding structures.

Research Features
Sierra Software for Electrodiagnostics

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

Efficiency, accuracy, and customizability are key in electrodiagnostics. Sierra software seamlessly integrates electromyography (EMG), nerve conduction studies (NCS), Neuromuscular Ultrasound (NMUS), and evoked potentials (EP), creating an efficient workflow tailored to your needs.

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.

Product availability varies across different countries and regulatory regions.
Citrix Ready
As a Citrix Ready partner, Sierra software has been tested and validated to ensure seamless integration with your Citrix environment.

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.

Sierra EMG/NMUS Concurrent Mode
Enable synchronized acquisition of ultrasound and EMG with the EMG/US Guidance+ protocol in Sierra 4.1 software.

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

Sierra NCS+

Motor + Sensory

Motor and Sensory

Motor + F Wave

Median and F Wave

CTS Strategy

CTS strategy

Trace History and Trials

See the entire stim history at once or one trace at a time. Save multiple trials per site.

trace history and trials

Live and Post Hoc Averaging

Average or exclude traces post acquisition using either trace history option.

live and post hoc averaging

Visible Reference Limits

Show the reference limits on traces during cursor adjustment or review.

Show Ref Limits Latency

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

Anatomy Navigator

Use Anatomy Navigator to quickly filter muscles, tests, and scanning sites, or auto-populate commonly tested muscles.

Sierra EMG+ AutoMUP

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.

Sierra SFEMG+ Protocol

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.

Nerve HD preset optimizes image processing for improved clarity of internal nerve structures. Easily zoom in to better visualize the epineurium or measure individual fascicles.

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.

Video shows Dual / Quad Image feature in NMUS+ that can be used to compare echogenicity of structures while scanning or during review. The snapshot feature can stitch the images together into a single image..

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
Sierra MUNIX+ Protocol

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.

Q-Mode can be used to quantify echogenicity of a structure, displaying live results as well as histogram analysis of a region of interest for research and tissue comparison.
Sierra Sample Report

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 Clinical Information Management

CadLink: Secure Data Management

Access data securely and efficiently with CadLink® data management software. The software provides enterprise-level patient and database management for EMG, EEG, and IONM, with secure, bidirectional HL7 integration for seamless integration with the enterprise EMR.
Doctor and Technician reviewing in remote review via CadLink

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.