Delivering Confidence and Simplicity during Neuromuscular Blockade
TetraGraph is a quantitative neuromuscular transmission monitor based on electromyography (EMG). The TetraGraph monitor stimulates, measures, analyzes and displays muscle function in surgical patients receiving neuromuscular blocking agents (NMBAs). NMBAs are used in almost 50% of surgical cases. Inadequate reversal of NMBAs can lead to residual neuromuscular blockade (RNMB). RNMB delays recovery and can lead to life-threatening complications. To prevent complications, quantitative neuromuscular monitoring is rapidly becoming the standard of care when NMBAs are administered.
The TetraGraph monitor is easy to use and features gold standard EMG technology for accurate measurements to bring confidence to the anesthesiology practice. The device has a quick start up time and does not require calibration. The arm can be tucked under surgical drape and can thus be used in all types of procedures, including cardiac, neuro, laparoscopic, robotic and bariatric surgeries. TetraGraph can be used from start to finish during the surgical procedure. The monitor enables objective assessment and facilitates titration of medication dosage to help clinicians determine when the patient’s neuromuscular block is sufficiently reversed to allow adequate spontaneous breathing. TetraGraph is small and portable and can travel with the patient to different settings like OR, PACU or ICU. The TetraGraph can be operated connected to mains electricity or battery operated.
Neuromuscular Transmission is the transfer of an electrical impulse between a motor nerve and its associated muscle. A Neuromuscular Transmission (NMT) monitor indicates the depth of neuromuscular block by stimulation of a peripheral motor nerve and evaluating the evoked muscle response (compound muscle action potential, CMAP). Transmission of impulses from the nerve to the muscle is blocked by neuromuscular blocking agents (NMBAs) causing transient muscle weakness and preventing the patient from moving and breathing spontaneously.
Muscle relaxation is used during general anesthesia to enable endotracheal intubation and to provide optimal surgical conditions. In critical care, muscle relaxation may be used during mechanical ventilation. In these circumstances, TetraGraph can be used as an objective monitor of Neuromuscular Transmission.
TetraGraph undertakes this function by periodically delivering electrical stimulation to the peripheral nerve and directly measuring the evoked electromyographic (EMG) response of the muscles (compound muscle action potential, CMAP). This provides a precise and automatic measurement of muscle response to a stimulus.
Like other technologies, EMG involves stimulation of a peripheral nerve and measurement of the response that is generated by the contraction of the innervated muscle. The difference from other technologies is that EMG measures an electrical event that occurs at the neuromuscular junction; the activation of postsynaptic receptors by acetylcholine (a chemical process) that converts it to a mechanical response (excitation- contraction coupling), that results in muscle contraction. Because measurement of function does not depend on physical movement (as MMG, AMG or KMG require), EMG is a better indicator of pure neuromuscular function- EMG is the new gold standard.
Neuromuscular Transmisson (NMT) is the transfer of an impulse between a nerve and a muscle in the neuromuscular junction. EMG measures the compound action potential, which is the first signal we are able to measure after neuromuscular transmission. Therefore, EMG is most specifically suited to monitor the effect of muscle relaxants without any mechanic interferences.
TetraSens electrode array has two proximal stimulating electrodes, one recording electrode and one reference electrode. The application is easy and quick. TetraSens electrode array is for single-patient use in order to avoid cross contamination. The electrodes can be applied on either hand, with the stimulation electrodes over the ulnar nerve at the wrist and the evoked response recorded from any of the hand muscles; typically, either the muscle at the base of the little finger (abductor digiti minimi muscle), or, more commonly, from the muscle at the base of the thumb, adductor pollicis muscle. TetraSens can also be placed on the FDI muscle (first dorsal interosseous). When the hand is inaccessible, the posterial tibial nerve (flexor hallucis brevis muscle), can be used for NMT monitoring.
Service is essential to keep medical equipment operational and safe. Our Nordic service team consists of experienced service technicians stationed across the Nordic countries. Our service technicians are ready to take on your every service need.”
The dual-valved LiteAire MDI holding chamber: Collapsible, disposable paperboard design.
The LiteAire® collapsible MDI holding chamber is a unique MDI holding chamber and an innovative alternative. LiteAire’s unique dual-valved MDI holding chamber design delivers pop-up convenience and effective drug output at a fraction of the cost of most plastic holding chambers. In many clinical settings, the LiteAire can reduce costs by replacing existing rigid plastic holding chambers or inefficient spacers with a paperboard alternative. The unique design allows the LiteAire to be reused by a patient over multiple doses and meets and often exceeds the performance of plastic holding chambers.
Anesthesia breathing circuit and kits
Limb-O™ single limb anesthesia breathing circuit and kits. Each Limb-O™ circuit is divided by a flexible septum running the length of the tube. Limb-O™ effectively transfers heat from the expiratory to the inspiratory side of the circuit. Increased thermal efficiency rates during surgery keeps gases warm and body temperature normothermic.
Less weight means less torque on the ET tube and less plastic is being used. Decreased compliance helps lead to accurate delivered volume. Accomplish more with less as the single limb design services pediatric through adult patients. Limb-O™ as all Vyaire circuits are made without latex.
Phototherapy positioning aid
Effectiveness – combined with security and stability with our Bilitex positioning aid specifically developed for phototherapy. The little patients are prone to stretch patterns and nervous movements, particularly during therapeutic phases. This is due to lack of muscle tone and the unbounded surroundings, which cost a lot of energy. With the Bilitex positioning aid, the preemie experiences a secure and flexible environment during therapy, which allows the infant to adopt a relaxing position.
The innovative textile material features a special mesh structure with 85% permeability to the high-intensity radiation spectrum. In addition, the knit fabric is very soft and breathable – the desired size can be individually adjusted using a flexible closure (Velcro®). The product is developed in cooperation with the University Hospital in Tubingen. It is tested and certified according to Oeko-Tex®Standard 100.
Reliable respiration monitoring
The SISS BABYCONTROL monitors respiration of babies and infants and can thus provide reliable assistance against «Sudden Infant Death». High reliability, simple operation and convenient size make the SISS BABYCONTROL® a universally applicable instrument for baby monitoring in hospitals or at home.
Being prepared
Still today, “Sudden Infant Death” is an unforeseeable occurrence. 80% of the affected infants are entirely healthy beforehand. Only 20% are from so-called risk groups (former premature births or babies already suffering from life-threatening conditions or with a «Sudden Infant Death» among close relatives). Only a prompt alarm in the event of irregularities provides the chance to apply life-saving measures within the shortest possible time. Such measures should be learned beforehand in special courses.
Timik AB
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191 40 Sollentuna
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