Pulse Oximetry Product Presentation Viamed Ltd

Agenda Pulse Oximetry What is a pulse oximeter? What is pulse oximetry? Why is pulse oximetry important? Where & when is pulse oximetry used? How do we measure oxygen saturation? What is a pulse oximeter? How does a pulse oximeter and sensor work? Pulse Oximetry Sensors 2000 & 3000 Series Viamed 4000 Series OxiMax tester VM-2160 Hand Held Pulse Oximeter VM-2160 Accessories VM-2101 Finger Oximeter VM-2105 Silicone Finger Oximeter Summary & Conclusion

What is Pulse Oximetry? Pulse oximetry is a non-invasive method concerned with the monitoring of a patient’s blood oxygen saturation level. Blood Oxygen Saturation The degree to which the oxygen-carrying capacity of haemoglobin is saturated with oxygen, normally 98-100%.

Why is Pulse Oximetry important? To ensure the patient has an adequate supply of oxygen to the whole body. When patients do not have enough oxygen ‘hypoxia’ can result Hypoxia When the whole or region of the body is deprived of oxygen Symptoms include: headaches, fatigue, shortness of breath, a feeling of euphoria and nausea. In severe hypoxic cases changes in levels of consciousness, seizures, coma and death. A patient’s SpO2 level is the most common and widespread monitored parameter. Nellcor and Masimo are the market leaders

Where & when is pulse oximetry used? Pulse Oximetry is used in a variety of situations: Throughout anaesthesia during surgery During the recovery phase In intensive care during ventilation In wards and casualty departments When patients are sedated for procedures such as endoscopy In patients with longstanding respiratory disease

How do we measure oxygen saturation? Blood oxygen saturation is measured using a pulse oximeter and a pulse oximetry sensor attached to the patient.

What is a pulse oximeter? A convenient non-invasive measurement instrument. Measures the oxygen saturation of a patient's blood and changes in blood volume in the skin. An oximeter detects hypoxia before the patient becomes clinically cyanosed. Most monitors also display the heart rate. The unit displays the percentage of haemoglobin saturated with oxygen together with an audible signal for each pulse beat, a calculated heart rate and in some models, a graphical display of the blood flow past the probe. Audible alarms which can be set by the user are provided. Pulse oximeters are of critical importance in emergency medicine and are also very useful for patients with respiratory or cardiac problems. A pulse oximeter can be a stand alone unit or alternatively can be incorporated into a multi-parameter patient monitor.

How does a pulse oximeter work? The pulse oximeter consists of a probe attached to the patient's finger, toe, ear lobe, nose or forehead which is linked to a computerised unit. Acceptable normal ranges of oxygen saturation are from 95 to 100 percent. For a patient breathing room air, at sea level, Typically the probe has a pair of small light-emitting diodes (LEDs) that shine through a translucent part of the patient's body, usually a fingertip or an earlobe, onto a photodiode. One LED is red, with wavelength of 660 nm, and the other is infrared, 905, 910, or 940 nm. Absorption of these wavelengths differs significantly between the oxygenated and deoxygenated haemoglobin. Therefore from the ratio of the absorption of the red and infrared light the oxy/deoxyhaemoglobin ratio can be calculated – i.e. the blood oxygen saturation level (expressed as a %). Haemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of the blood in vertebrates and other animals. In mammals the protein makes up about 97% of the red cell’s dry content, and around 35% of the total content (including water). Hemoglobin transports oxygen from the lungs or gills to the rest of the body, such as to the muscles, where it releases its load of oxygen. Hemoglobin also has a variety of other gas-transport and effect-modulation duties, which vary from species to species, and may be quite diverse in invertebrates. Oxyhemoglobin is formed during respiration when oxygen binds to the heme component of the protein hemoglobin in red blood cells. This process occurs in the pulmonary capillaries adjacent to the alveoli of the lungs. The oxygen then travels through the blood stream to be dropped off at cells where it is utilized in aerobic glycolysis and in the production of ATP by the process of oxidative phosphorylation. It does not, however, help to counteract a decrease in blood pH. Ventilation, or breathing, may reverse this condition by removal of carbon dioxide, thus causing a shift up in pH.[7] Deoxyhemoglobin is the form of hemoglobin without the bound oxygen. The absorption spectra of oxyhemoglobin and deoxyhemoglobin differ. The oxyhemoglobin has significantly lower absorption of the 660 nm wavelength than deoxyhemoglobin, while at 940 nm its absorption is slightly higher. This difference is used for measurement of the amount of oxygen in patient's blood by an instrument called pulse oximeter.

Pulse Oximetry Sensors Aristo Comp2/Sat 800 Series 2000 & 3000 Series Viamed 4000 Series

2000 & 3000 Series Sensors 2000 Series Includes: Reusable finger sensors Reusable multi-site ‘Y’ sensors Disposable sensors Extension cables Adapter cables Cost Effective Easy to apply Durable High performance 3000 Series Includes: Nellcor compatible disposable sensors Compatible with most OEMs Disposable Sensors: Variety of application sites: finger, great toe, foot Variety of sizes: adult, paediatric, infant, neonatal Variety of tape material: cloth, foam, vinyl

Viamed 4000 Series Sensors Series includes Easy to use 3rd generation soft silicone sensors Reusable finger sensors Reusable wrap sensors Disposable sensors Extension & adapter cables Easy to use High performance Reliable and accurate Either original or fully compatible replacement sensors

4000 Series Disposable SpO2 Sensors Patient types available Adult Paediatric Infant Neonatal Tape materials available Micro Foam Transpore Plaster Cable lengths available Adult & Paediatric – 0.45m (18”) Infant & Neonatal – 0.90m (3’)

4000 Series Soft Sensors 3rd generation soft silicone sensors Extremely robust and durable Extremely accurate Comfortable and secure fit Patient Types Available Adult Paediatric Bio-compatible and latex free silicone to help prevent allergic reactions Can be easily and thoroughly cleaned

4000 Reusable Sensors Finger Sensors Wrap Sensors Extension Cables Robust and reliable Comfortable fit Quality design

OxiMax Tester Used to identify whether the Nellcor monitor is using OxiMax or non-OxiMax technology

VM-2160 Pulse Oximeter Displays oxygen saturation, pulse rate with audible pulse tones Includes a 3rd generation soft silicone sensor Clear bright, colour OLED display A range of both reusable and disposable sensors are available Ergonomic design Various mounting options are available: Lanyard Universal mounting clamp Pole & rail clamps… Protective silicone boot Various language options are available High & Low adjustable alarms Lightweight and compact with durable silicone protector boot Ability to store and restore patient waveforms and trend data Standard 3 x AA batteries Trend data can be downloaded onto a PC via USB connection (software included) Long term trending: up to 48 hours Short term trending: 15 min / 30 min / 4 hours

VM-2160 display options The VM-2160 has a number of display formats: Default Display Short Term Trending Display Data Management Display Large Digit Display

VM-2160 Accessories Accessories available: Reusable Adult Finger Sensors Reusable Paediatric Silicone Finger Sensors Silicone Wrap Sensors Disposable Sensors Extension Cables Universal Mounting Clamp Pole, Rail and Wall Mounts Carrying Case and Armband

VM-2101 Finger Oximeter For spot monitoring of oxygen saturation and pulse rate. Lightweight Low profile Large display Clear and bright, colour OLED display Display can be viewed in 4 rotations Large, clear Pleth waveform is displayed on 2 rotations Large digit display formats Adjustable brightness Colour coded signal quality and signal strength indicator (green – good, yellow – weak, red – poor) Easy to use; 1 button operation Automatic power off when finger is removed Accessories included: 2 x AAA batteries Lanyard Optional Accessories: Carry Case, with belt loop, colour – black Carry Case, with belt loop, colour - orange Meets ISO 9919:2005 Standards (shock, vibration, water ingress and drop tests…) 16 bit processing facilitates low perfusion capabilities

VM-2105 Silicone Finger Oximeter Unique soft silicone housing for superior comfort and fit Robust – no hinge assembly 16 bit processing facilitates low perfusion capabilities Clear and bright, colour OLED display Display can be viewed in 4 rotations Pleth waveform, displayed in 2 rotations Colour coded signal quality and signal strength indicator Adjustable brightness Meets ISO 9919:2005 Standards; shock, vibration, drop and water ingress tests… Also available in grey.

Summary & Conclusion Pulse Oximetry What is a pulse oximeter? What is pulse oximetry? Why is pulse oximetry important? Where & when is pulse oximetry used? How do we measure oxygen saturation? What is a pulse oximeter? How does a pulse oximeter and sensor work? Pulse Oximetry Sensors 2000 & 3000 Series Viamed 4000 Series OxiMax tester VM-2160 Hand Held Pulse Oximeter VM-2160 Accessories VM-2101 Finger Oximeter VM-2105 Silicone Finger Oximeter