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 syringe infusion pump from arcomed´s Chroma Series is an all-in-one infusion pump that meets all your anaesthesia needs. Syramed can be used as a total intravenous anaesthesia pump (TIVA) or target controlled infusion pump (TCI) in the OR. It can follow the patient to the recovery room and be used as a patient controlled analgesia (PCA) pump or be used as a standard infusion pump in the ICU and in general wards – and more.
Syringe pumps are used to administer medication that have very small hourly volumes. Syramed high-quality syringe infusion pump improves patient treatment by increasing safety in procedures and simplifying workflow for nurses. Syramed is user-friendly and intuitive and fulfil the sophisticated needs of hospitals with the same external shape, interface, design and functionality for both syringe and volumetric pumps. Syringe infusion pumps from arcomed are known for simple construction and user-friendly core features when delivering continuous and very specific amounts of fluids at the rates the patient acquires
The volumetric infusion pumps from arcomed´s Chroma Series is an all-in-one infusion pump that meets all your anaesthesia needs. Volumed can be used as a total intravenous anaesthesia pump (TIVA) or target controlled infusion pump (TCI) in the OR. It can follow the patient to the recovery room and be used as a patient controlled analgesia (PCA) pump or be used as a standard infusion pump in the ICU and in general wards – and more.
Volumed high-quality volumetric infusion pump improves patient treatment by increasing safety in procedures and simplifying workflow for nurses. Volumed is user-friendly and intuitive and fulfil the sophisticated needs of hospitals with the same external shape, interface, design and functionality for both syringe and volumetric pumps. Volumetric infusion pumps from arcomed are known for simple construction and user-friendly core features when delivering continuous and very specific amounts of fluids at the rates the patient acquires.
Solution for continuous core temperature monitoring
The temperature variable is a key indicator of the patient’s febrile state. The continuous nature of the measurement is quite difficult to obtain and only a few restrictive devices (rectal, esophageal probes, etc.) allow continuous core temperature monitoring.
eCelsius Medical, class IIB medical device, is a miniaturized electronic ingestible capsule that transmits core temperature data continuously. The capsule communicates in real time with a dedicated monitor, e-Viewer Medical, at a sampling period of 30 seconds. This monitor allows data recording, and an alert may be triggered if a threshold has been exceeded. The communication distance between the capsule and the monitor ranges from 1 to 3m (depending on environment and patient).
The capsule also has its own memory. In the case of a communication disruption between the monitor and the capsule, an a posteriori automatic synchronization of the data is performed.
Insight Watch – Medical-Grade actigraphy monitoring, redefined
The compact and stylish CentrePoint Insight Watch captures and records continuous high-resolution raw acceleration data, sampled up to 256 Hz, to support the development of novel endpoints related to real-world activity, mobility, and sleep behaviors to provide objective, real-world physical activity, mobility, and sleep measures, in near real time.
Used in conjunction with the CentrePoint Data Hub or mobile application, captured data is passively transmitted to the cloud for near real-time detection of compliance issues and potential data trends.
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