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WELCOME TO the Next Generation TetraGraph Era Navigating the New Frontier of Precision Beyond Twitch Monitoring

NEXT GENERATION TETRAGRAPH the Future of TOF Monitoring Smart Accurate Essential Redefining EMG Monitoring Experience Seamless Monitoring with TetraGraph s Intelligent Design and Unmatched Precision Next generation TetraGraph invigorates the field of perioperative monitoring with quantitative train of four TOF advancements Its TetraGraph Level of Block GaugeTM simplifies data interpretation across all phases of anesthesia and neuromuscular block

Achieving optimal signal strength ensures precise sensor placement enhancing the accuracy even at profound levels of neuromuscular block Large high resolution non glare display 2 5x bigger for enhanced visibility Senzime s TetraGraph Adaptive IntelligenceTM aids in signal strength optimization and automates workflows in accordance with guidelines from the American Society of Anesthesiologists ASA and the European Society of Anaesthesia and Intensive Care ESAIC Its advanced 6th generation EMG algorithm analyzes muscle function at 4 times higher resolution delivering unmatched accuracy and sensitivity in muscle function analysis TetraGraph features a slim portable design to augment a dynamic OR with multiple mounting options and seamless connectivity Accommodating complex patients and procedures like robotic and tucked arm cases its sustainable footprint and future proof platform assures lasting reliability top tier performance and facilitates software upgrades TetraGraph brings the future of quantitative TOF monitoring to reality

Incidence of rNMB is 20 1 PACU LOS increases on average 80 minutes2 Reduces rNMB by 66 3 Reduces reversal drug costs by 40 4 TACKLE THE Challenge of Residual Elevating Patient Safety and Outcomes Neuromuscular Block by Advancing Beyond Conventional Techniques The Clinical Problem Residual Neuromuscular Block The Solution TetraGraph EMG based Monitoring Residual neuromuscular block rNMB remains a challenge in perioperative care that contributes to increased postoperative complications prolonged recovery times and higher healthcare costs Despite advancements in anesthesia rNMB afflicts countless surgical patients with respiratory distress muscle weakness increased risk of critical respiratory events and other severe conditions EMG based monitoring ensures precise detection of residual block through accurate real time neuromuscular assessments with higher sensitivity and specificity than traditional methods Priority 1 Patient Safety EMG based monitoring complies with ASA and ESAIC guidelines Trustworthy TetraGraph aligns with best practices and enhances patient safety protocols References 1 1 Alenezi F Alnababtah K Alqahtani M et al The association between residual neuromuscular blockade RNMB and critical respiratory events a prospective cohort study Perioper Med 10 14 2021 2 M urphy GS Brull SJ Quantitative Neuromuscular Monitoring and Postoperative Outcomes A Narrative Review Anesthesiology 2022 Feb 1 136 2 345 361 3 Glenn S Murphy Sorin J Brull Quantitative Neuromuscular Monitoring and Postoperative Outcomes A Narrative Review Anesthesiology 2022 136 345 361 doi https doi org 10 1097 ALN 0000000000004044 4 L ori Ann Edwards Nam Ly Jonathan Shinefeld Gordon Morewood Universal quantitative neuromuscular blockade monitoring at an academic medical center A multimodal analysis of the potential impact on clinical outcomes and total cost of care Perioperative Care and Operating Room Management Volume 24 2021 100184 ISSN 2405 6030 https doi org 10 1016 j pcorm 2021 100184

Why Forgo Conventional Techniques for EMG Train of Four Monitoring Unmatched Precision The 6th generation TetraGraph EMG algorithm offers 4x higher resolution measuring compound muscle action potential CMAP with greater precision than other methods to ensure absolutely accurate neuromuscular assessments Independent of Limb Movement Unlike traditional monitoring techniques TetraGraph EMG can work without the need for unimpeded thumb movement during surgery allowing for arm positioning flexibility such as tucked arms allowing for the arms to be positioned tucked under surgical drapes Seamless Integration Senzime TetraGraph complements external multiparameter monitors and electronic health records to automate charting and maximize direct patient care Clinical Validation and Study Results The latest clinical study published in Anesthesiology 2024 demonstrated that TetraGraph achieves significantly better accuracy and precision than other monitors when measuring baseline TOF ratios EMG monitors produced results similar to the clinical reference standard mechanomyography MMG reinforcing their reliability for quantitative TOF monitoring 1 Reference 1 Wedemeyer Z Michaelsen KE Jelacic S Silliman W Lopez A Togashi K Bowdle A Anesthesiology 2024 https doi org 10 1097 ALN 0000000000005051 TetraGraph EMG Other EMG Devices Clinically validated at all levels of block including deep and profound blocks Yes No Proprietary Level of Block GaugeTM for easy to interpret high resolution Yes No real time display of individual EMG readings waveforms CMAPs and trends TetraGraph Adaptive IntelligenceTM to to aid in signal strength Yes No optimization providing confidence in the accuracy of every reading Backed by over 40 years of research and developed with insights Yes No from global leaders in anesthesiology 6th generation advanced EMG algorithm with 4x resolution superior Yes No artifact handling and noise cancellation without the need for extra ground electrodes Complete sensor portfolio from infants to adults with sensitive skin Yes No

Real Time Trend Graph A real time graph featuring a secondary y axis that displays the Level of Block allowing for straightforward interpretation of the gauge Updates are made instantly as new data are added Post Procedure Data Review Review post procedure data on a full screen highresolution trend display with intuitive zoom in controls A dynamic line tool allows for the selection of specific values or time points within the trend graph for detailed insights

Proprietary TetraGraph Level of Block GaugeTM TetraGraph uses our proprietary Level of Block GaugeTM an innovation that evolved from our enduring dedication to precision based patient monitoring This essential component continues to raise quantitative TOF monitoring market standards in personalized anesthesia Intuitive Interface for Data Trends SIMPLY INTELLIGENT Next Generation TOF Monitoring TetraGraph features an intuitive interface so clinicians can easily view and analyze patient data trends enhancing decision making and patient management throughout the perioperative period including both real time and post procedure reviews Introducing the First Ever Level of Block Monitor with TetraGraph Adaptive IntelligenceTM EMG Analysis Made Smart Reimagined in TetraGraph technology intelligent EMG analysis with Peak to Trough PtT analytics gives clinicians the added assurance of industry leading accuracy and optimum patient centered care Every possible surgical case is familiar to our 6th generation EMG algorithm Powerful computations are automatically formulated from a knowledge base comprising millions of waveforms

THE NEW STANDARD of TOF Accuracy Surpasses Traditional Twitch Monitoring If monitoring cannot begin before muscle relaxants are administered TetraGraph Adaptive Intelligence provides an estimated objective signal strength reading to guide precise sensor placement thereby ensuring accurate and reliable monitoring Proprietary TetraGraph Adaptive IntelligenceTM Series of Specialized Algorithms Automates Your Workflow from Induction to Recovery Sensor Placement Optimization Aids in optimal sensor placement and signal strength for accurate monitoring of neuromuscular block TetraGraph Adaptive PTCTM Enters Deep Block Mode automatically when TOFC is 0 using a single stimulation to check response amplitude and signal quality If conditions are met it proceeds with tetanic stimulation and PTC measurements Otherwise it returns to TOF mode ensuring safe and efficient deep block management Adaptive Time Interval Adjusts measurement intervals automatically based on neuromuscular response changes ensuring more precise assessments and capturing spontaneous recovery without omission

15 mV Patented Advanced Noise Cancelling Technology Senzime s TetraGraph system features patented noise canceling technology providing clinicians with precise and reliable patient monitoring during anesthesia Its innovative design filters out operating room noise by generating a single stimulus signal and measuring noise when no response is expected to ensure clean and accurate data Unlike other monitors that require extra ground electrodes for noise cancellation TetraGraph integrates this function into its software enhancing ease of use improving patient safety and bolstering the anesthesia provider s confidence

VERSATILE for a Wide Range of Patients and Procedures Revitalizing the Modern OR with Clinician Centric Connectivity Next Generation TetraGraph Engineering Precision in Every Measure Next generation TetraGraph was developed with modifiable portability to meld into a dynamic OR environment where every device is as vital as every member

Connects with Senzime s family of flexible EMG sensors offering 12 or 18 cables to adapt to various surgical procedures such as those with space and movement limitations like tucked arm and robotic cases TetraSens Adaptable for adult patients ensuring precise neuromuscular monitoring for a wide range of surgical procedures TetraSensitive Customized for geriatrics and patients with sensitive skin Hypoallergenic and latex free with soft edges including low profile design TetraSens Pediatric Ultrasoft flexible material and the only FDA cleared sensor with a separate and specific pediatric indication enabling one sensor for infants to adolescents Industryleading options combine seamless integration with external multiparameter monitors and electronic patient health records for an uninterrupted linear workflow

MEETING Tomorrow s Demands Today Designed in Partnership with Clinicians Across the Globe Compelling reasons to bring a value based sustainable and future proof solution into the OR Evolving from 40 years of research and feedback from patients and clinicians the TetraGraph system was invented and tested in the USA developed and manufactured in Sweden and is now helping patients in over 30 and counting countries worldwide Developed and manufactured in Sweden with sustainability built in as the first TOF monitor incorporating biocompatible materials and a fossil free energy final manufacturing and assembly process in Uppsala Sweden Future proof upgradable platform ready for upcoming software features to keep TetraGraph the State of the Art in technological innovation Sorin J Brull MD FCARCSI Hon The visionary behind TetraGraph pioneered the technology with over four decades of research and clinical practice

Our community of healthcare providers trusts our unwavering commitment to excellence and utilizes a comprehensive array of features with personalized support from our dedicated team Our technology prevails in the most demanding conditions to achieve superior patient care With over 100 years of combined critical care and anesthesia experience our clinicians will help integrate our technologies into any medical environment for meaningful outcomes that justify your investment every day CLINICAL EDUCATION IMPLEMENTATION SUPPORT Explore Senzime Academy Our eLearning platform is designed to help anesthesia providers master all the capabilities of the TetraGraph system quickly and effectively Our free online courses ensure compliance with clinical guidelines and enhance patient safety Access training anytime anywhere or use our exportable SCORM files for integration into your hospital s learning management system LMS POST GO LIVE ONGOING SUPPORT Stay updated and advance your practice at your own pace with Senzime Academy

TECHNICAL SPECIFICATIONS Modes of Operation TOF Interval 15 seconds 60 minutes Recording Range 0 1 50 mV Automatic stimulus setup Train of Four TOF Ratio TOF Count Post tetanic Count PTC Automatic detection of maximal current Supramaximal current 20 above maximal current 4 pulses of 200 or 300 s duration at 2 Hz repeated at user selected frequency of 15 seconds 1 minute 5 minutes 15 minutes or 60 minutes PTC consists of Tetanic Stimulation a set of 250 pulses 1 pulse at 50Hz over 5 seconds fixed at 50mA 200 s followed by up to 20 ST pulses at 1 Hz 50 60 Hz filter Measurement Graphics Display MAP Muscle Action Potentials TOF TOFC Yes Peak to Peak MAP Color LCD Brightness control Touch Screen interface Display of waveforms Bar of four pulse amplitudes and trend of successive TOFR values TOF Count integer and trend Single Twitch ST Pulse of 200 or 300 s duration at ST 10 or 5 seconds Amplitude of response mV series of response amplitudes as bars Stimulation Current Pulse Width 0 60 mA 5k ohm 200 s or 300 s PTC Number of post tetanic count Power Supply Charger EN 60601 1 certified power supply 5V DC Pulse Type Voltage Monophasic square wave 300V Connection to TetraGraph must only be used mains electrici with the provided power supply ty during use adapter Sensor Type Battery 8 hours continuous operation with new battery in good condition Integrated strip TetraSens disposable stimulator sensor recorder Battery Specifications Rechargeable Lithium battery Fey Elektronik Sensor stimulus Ulnar nerve or Posterior Tibial placement nerve Cord length 3 meters Sensor recording placement Adductor Pollicis muscle AP Abductor Digiti Minimi muscle ADM Flexor Hallucis Brevis muscle FHB Duration of use Single use cumulative use less than 24 hours on the same patient

Dimensions Length Width Thickness Weight 215 millimeters 116 millimeters 38 millimeters 85 millimeters including pole clamp 573 grams 748 grams including pole clamp Environment during storage and movement between hospital location Temperature 20 C to 60 C 4 F to 140 F Relative humidity Atmospheric pressure 10 to 95 non condensing 50 kPa to 106 kPa Additional Features Case Reference 8 digit number Number Audible stimulus On Off Data review On screen review of trend data Environment during use Temperature 5 C to 40 C 41 F to 86 F Relative humidity Atmospheric pressure 10 to 95 non condensing 70k Pa to 106 kPa Data Interface TetraGraph Philips Interface Connectivity Philips Capsule Masimo DCXTM Philips IVOI Data Management TetraConnect cloud based connectivity portal to upload view share and export data Communication USB C connector Interface Connected equipment USB C 2 0 or higher Patient Cable Cord length 3 65 meters Standards Applied IEC 60601 1 2005 AMD1 2012 AMD2 2020 EN 60601 1 2 2015 AMD1 2020 IEC 60601 2 40 2016 Redefining Quantitative Train of Four TOF Monitoring with the Industry s First Ever Level of Block GaugeTM TetraGraph Adaptive IntelligenceTM

COMMITMENT TO Patient Safety Our commitment propels healthcare providers to reach a new level of patient care where every clinician is empowered every patient assured and the highest standards of care are not just met they re invented Learn more Senzime com NextGen INFO0133 v1 0