TZ Medical - February 2020

Take a look at our newsletter this month.

THE TIMES

FEBRUARY 2020

HOW STRONG PARTNERSHIPS DRIVE OUR COMPANY FORWARD A MARRIAGE OF MINDS ARC EXCLUSION AREA An exclusion area has been specifically developed to allow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. ARC EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. ARC EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has been specifically developed to allow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. 17750 SW Upper Boones Ferry Rd., Ste. 150, Portland, OR 97224 | TZMedical.com | 800-944-0187 PROCEDURE LIGHTING ARC

SECONDARY LOGOS/ CATEGORY LOGOS

HEMOSTASIS

SECONDARY LOGOS/ CATEGORY LOGOS

HEMOSTASIS

HEMOSTASIS SECONDARY LOGOS/ CATEGORY LOGOS ELECTROPHYSIOLOGY HEMOSTASIS SECONDARY LOGOS/ CATEGORY LOGOS

ELECTROPHYSIOLOGY HEMOSTASIS SECONDARY LOGOS/ CATEGORY LOGOS

Valentine’s Day is just around the corner, and romance is in the air. Every February feels like floating through a sea of candy hearts, jewelry ads, and happy couples, but here at TZ Medical, we’re celebrating a different kind of partnership this month: the many “marriages” we’ve forged with our inventors. It’s not an exaggeration to say that partnerships both steer and fuel our company. Without the numerous nurses, physicians, technologists, and other inventors we work with nationwide, we wouldn’t be able to make the game-changing innovations we have in the medical field in general, and the cath lab in particular. Some of these partnerships date back decades, and they’re built on the same bedrock as conventional marriages: iron-clad trust, mutual support, and complementary strengths. A perfect example of this is our partnership with Dr. Greg Gordon of United Vascular in Omaha, Nebraska. For the past two years, our team has worked side by side with Greg to bring his product, the revolutionary StandTall, to market. Greg brought his brilliant idea to the table when he met Trent and the rest of our team at a trade show, and we brought our nationwide reach. “I’m an interventional radiologist, and I started my own medical device company six or seven-years ago,” Greg explains, “but when I had worked through the process and finally got my product out for commercialization, I realized that I had no distribution means.” That’s where we came in. Our team of experts introduced the StandTall to cath labs nationwide, showing them the benefits of using its intuitively designed external vascular sheath extender to redirect workflow to the right during left radial procedures. We offered Greg and United Vascular open lines of support and communication throughout the process. TZMedical Sparkedbyyour ideas TZMedical Sparkedbyyour ideas PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedical Sparkedbyyour ideas PROCEDURE LIGHTING PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedical Sparkedbyyour ideas ROCEDURE LIGHTING PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedical Sparkedbyyour ideas PROCEDURE LIGHTING PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedical Sparkedbyyour ideas ARC PROCEDURE LIGHTING PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedic l Sparkedbyyour ideas ARC PROCEDURE LIGHTING PATIENT POSITIONING WORKPLACE SAFETY RADIATION PROTECTION TZMedic l Sparkedbyyour ideas TZMedical Sparkedbyyour ideas TZMedical Sparkedbyyour ideas “The partnership has been fantastic, to the point that TZ is our exclusive distributor now. We’ll probably do a second product with them as well, and I can see future cooperation with them on a third, fourth, and fifth product that bring together the spark of our ideas and their execution,” Greg says. He ACCEPTABLE BACKGROUNDS Accept ble backgrou d images depend on how they are used. A good background will include t e TZ Blue color or o e of the tint color variations. (see page 17 for details on these colors.) Th background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Accept ble background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Accept ble backgrou d images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The backgr und s ould not be too distracting if there is large amount f text. Ke p the backgrounds simple and professional. EXCLUSION AREA An exclusion area has been specifically developed to allow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has been specifically developed to allow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ lett rs incorporated in the prim ry coin logo. EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has been specifically developed to allow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. EXCLUSION AREA An exclusion area has be n specifically developed to llow maximum clarity and legibility of the logo. The image below represents the exclusion area required around any application of the pri- mary logo. No type or graphic elements should intrude in this space. This area is measure by the capital width of the TZ letters incorporated in the primary coin logo. MINIMUM SIZE The logo should meet the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should meet the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should meet the minimum size requirement of 3/8 i . wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should m et the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should m et the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter f r the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. ACCEPTABLE BACKGROUNDS Acceptable background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Acceptable background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. TZMedical Sparkedbyyour ideas

DEFIBRILLATION ELECTROPHYSIOLOGY HEMOSTASIS

MINIMUM SIZE The logo should meet th minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should meet the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should m et the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should meet he minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should m et the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. diameter for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. MINIMUM SIZE The logo should meet the minimum size requirement of 3/8 in. wide for the logo with the tagline and 0.15 in. di met r for the logo without the tagline (the ‘coin’). When required in smaller sizes, use black (Positive) or White (reversed) versions of the logo. ACCEPTABLE BACKGROUNDS Acceptable background images depend on how they are used. A good background will include th TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Acceptable background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Accept ble background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Accept ble backgrou d images depend on how they are used. A good background will include the TZ Bl e color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Acceptable background images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional. ACCEPTABLE BACKGROUNDS Accept ble backgrou d images depend on how they are used. A good background will include the TZ Blue color or one of the tint color variations. (see page 17 for details on these colors.) The background should not be too distracting if there is a large amount of text. Keep the backgrounds simple and professional.

ELECTROPHYSIOLOGY

DEFIBRILLATION ELECTROPHYSIOLOGY HEMOSTASIS

NEUROSURGICAL DEFIBRILLATION ELECTROPHYSIOLOGY

DEFIBRILLATION

CARDIAC MONITORS NEUROSURGICAL DEFIBRILLATION

COMFORT ZONE CARDIAC MONITORS NEUROSURGICAL

NEUROSURGICAL

also spoke about running a company, “You want to control as much as you can and be involved in as much as you can, but at the end of the day, I’m good at certain things, and they’re good at certain things. We try to work with the best, and TZ makes us a bit better.” As beneficial as the partnership is for both sides, it couldn’t function without trust. We work to build that trust with our inventors from day one, assuring them that we’re as passionate about their ideas as they are and being transparent about our process in getting them to market. Describing his “first date” with Trent, John, and the rest of our team over coffee, Greg says, “It was very open-ended, a ‘getting to know you’ kind of discussion … It was very impressive in that TZ had the capacity to do a lot bigger things than we could, but they were still small enough for one- on-one communication. I liked that there wasn’t a lot of red tape. They were straightforward, and there were no games. We struck up a conversation, and the rest followed!” This month, in the spirit of the holiday, we’re reflecting on how grateful we are to have partners like Greg. Without the bright sparks they pass on to us, we wouldn’t be able to make the kind of difference we can in the cath lab today. So thank you, Greg, for helping us make the lives of patients and physicians easier — and happy Valentine’s Day to all of our partners!

COMFORT ZONE CARDIAC MONITORS NEUROSURGICAL

COMFORT ZONE CARDIAC MONITORS

CARDIAC MONITORS

COMFORT ZONE

COMFORT ZONE OGOS/ CATEGORY LOG S

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ECTROPHYSIOLOGY MOSTASIS OGOS/ CATEGORY LOGOS

PROCEDURE LIGHTING

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FIBRILLATION ECTROPHYSIOLOGY MOSTASIS

PATIENT POSITIONING PROCEDURE LIGHTING

PROCEDURE LIGHTING

PATIENT POSITIONING PROCEDURE LIGHTING

FIBRILLATION ECTROPHYSIOLOGY

WORKPLACE SAFETY PATIENT POSITIONING PROCEDURE LIGHTING

UROSURGICAL FIBRILLATION ECTROPHYSIOLOGY

WORKPLACE SAFETY PATIENT POSITIONING

UROSURGICAL FIBRILLATION

PATIENT POSITIONING

RADIATION PROTECTION WORKPLACE SAFETY PATIENT POSITIONING

RDIAC MONITORS UROSURGICAL FIBRILLATION

RADIATION PROTECTION WORKPLACE SAFETY

RDIAC MONITORS UROSURGICAL

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MFORT ZONE RDIAC MONITORS UROSURGICAL

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MFORT ZONE RDIAC MONITORS

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MFORT ZONE RDIAC MONITORS

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MFORT ZONE

RADIATION PROTECTION

–The TZ Medical Team

MFORT ZONE

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YOUR TRANSRADIAL ACCESS UPDATE WHAT’S NEW IN THE CATH LAB?

Transradial access (TRA) for the purpose of cardiac angiography and percutaneous cardiac intervention (PCI) has become an accepted approach within the United States and throughout the world. One of the first published accounts of TRA was in 1989 by Lucien Campeau of the Montreal Heart Institute. In a study of 100 patients, Campeau reported that TRA was safer than percutaneous access of the brachial artery with an 88% success rate. In 1992, KIiemenjj reported the first successful coronary stent placed via the TRA approach. While the TRA approach demonstrated an effective and safe alternative to the traditional transfemoral approach (TFA), this technique struggled to gain the same level of physician acceptance within the United States as it enjoyed in the rest of the world. Between 2004 and 2007, only 1.32% of all PCIs in the U.S. were performed using the TRA approach, compared to 10% worldwide and an even higher rate in Canada. The TRA approach continued to gain acceptance, and between 2008 and 2011, it grew to an estimated 27% within the U.S. and over 70% worldwide. A recent survey of cath lab leadership within the Pacific Northwest indicated well over 75% of those surveyed were performing TRA in their cath labs. Clearly, the TRA approach is growing in acceptance, and all indications are that this approach will become a future standard. Today, there is an abundance of data regarding TRA’s benefits, including a lower rate of bleeding and overall complications, especially regarding significant vascular complications. Most studies support that TRA has a lower overall cost as compared to the TFA approach, with the bulk of these savings centered on a reduced length of stay and reduced costs due to fewer vascular complications. As significant as all of these benefits are, the one that often stands out is a higher patient satisfaction rate, which supports an overall increase in quality of life. In some situations, early adoption of the TRA approach was forced on physicians when patients who had a previous angiogram performed via TRA asked for, or even insisted on, their next angiogram being performed via the radial artery as opposed to the femoral artery. TRA acceptance has also been supported by a variety of other elements. A huge increase in catheters, wires, and other equipment specifically designed for this approach has had a significant impact on the ease of use during the procedure, the overall success rate, and the reduction

in complications. Many physicians, especially graduating cardiology fellows, now view TRA as a standard. It has also been widely accepted by cath lab staff.

As noted, a key aspect of the TRA approach is postprocedure care, particularly regarding patient comfort and overall length of stay. Patients who experience this approach can ambulate much more quickly and do not have the bed rest and mobility restrictions associated with TFA. Some facilities have now incorporated a “lounge chair” approach for patients having a TRA procedure. One important aspect of TRA postprocedure care is quick and effective hemostasis. Like the catheters and wires specifically designed for TRA, products designed for radial artery hemostasis have also advanced in quality. Hemostasis bands are a crucial piece of equipment utilized to ensure quality outcomes. Important elements to consider when evaluating hemostasis devices include patient comfort, ease of application, visibility of the access site, cost, and ease of use specific to training. Ease of use and initial training are especially important for facilities that do not have a pre- or post-area associated with the cath lab but instead send their postprocedure patients to a step-down nursing unit. These nursing units often have additional staff, including staff who “float” from other units, all of whom need to understand the proper use of the hemostasis device. A device that meets the noted requirements will ensure optimal quality and outcomes. The future of TRA includes areas outside of the cardiac arena. The TRA approach is now being utilized for cerebral, abdominal, and peripheral vascular procedures. Advancements in technology are supporting these expanded techniques and treatments. Every facility should consider TRA as a basic component of quality patient care.

–Dan Scharbach INDEPENDENT HEALTH CARE CONSULTANT AND FORMER REGIONAL DIRECTOR FOR PROVIDENCE HEALTH SYSTEM

REFERENCES Fischman A. (2013). The time is now for transradial intervention. Endovascular Today Fornell D. (2016). Radial access adoption in the united states. DAIC

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ARE YOU CELEBRATING AMERICAN HEART MONTH? A LOOK BACK AT EFFORTS TO RAISE AWARENESS Here at TZ Medical, we spend an exorbitant amount of time thinking about the heart — including its functions, its weaknesses, and how we can help physicians and hospital staff like you keep it beating for patients across the country. The same can be said of the entire medical community. Because heart disease is a leading cause of death among Americans, heart health has been a major focus of research and education for decades. Over the years, the community has made strides in combating heart disease, and one of the biggest has been the collaboration and outreach that takes place every February during American Heart Month. The first American Heart Month was celebrated in 1963 following a proclamation made by President Lyndon B. Johnson. Speaking to the nation, Johnson said, “The people of the United States need to give heed to the nationwide problem of the heart and blood vessel diseases and to support the programs required to bring about its solution.” Since then, the American College of Cardiology reports that physicians and other professionals have made a point to collaborate on the problem during American Heart Month, sharing best practices, aligning measurements, advancing implementation strategies, and raising awareness nationwide by offering resources. Today, many Americans are well aware of the importance of the heart and what they can do to safeguard its health, but as you know, they aren’t following through with best practices. Heart disease is still a leading cause of death for both men and women — in fact, the Centers for Disease Control found that from 2014–2016, an American died from cardiovascular disease every 37 seconds. That said, we can’t give up on the fight to increase awareness, learn everything we can about heart disease, and ensure suffering patients are as comfortable as possible. Have you made plans to celebrate American Heart Month this year? If you’re intent on taking action to make a difference, our lineup of heart monitoring products can help you treat patients and keep a close eye on their heart functions along the way. To learn more about cardiac monitoring products like the Trident Holter Monitor, the Trident Pro 4-in-1 Monitor, and the Trident Holter Patch, visit TZMedical.com.

TAKE A BREAK

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INSIDE THIS ISSUE:

The Many ‘Marriages’ That Make TZ Tick

Your Transradial Access Update

Take a Break

A Brief History of American Heart Month

Cobra Board

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