Sometimes the most exquisite medical solutions aren't necessarily the most complex. And more often than is widely known, effective medical technologies emerge on battlefields or from emergency first responders. Such is the case with Estill Medical Technologies' (Dallas) Thermal Angel Blood and IV Fluid Infusion Warmer.

It's a small, simple, inexpensive ($99) battery-operated solution that keep patients normothermic.

A decade ago, two registered nurses produced a study that revealed the vast benefits of avoiding intraoperative hypothermia, which can cause a number of complications ranging from reduced resistance to wound infection to increased loss of blood. They deduced that these types of complications can cost $2,500 to $7,000 per patient (AANA Journal, April 1999).

"The idea for the Thermal Angel came from a fireman," Jay Lopez, Estill president told Medical Device Daily. "He knew there were significant issues when responding to accident scenes where they didn't have a way to warm fluids in the field. In the past, EM guys would put the IV bag in an armpit or on the dash of vehicle and turn on a car heater."

From that emerged the Thermal Angel, which for the last decade has been sold exclusively to the military for use on the front lines of war and anywhere that AC power was unavailable. Estill has just recently ramped up manufacturing capacity for a full commercial launch based on demand from military personnel who have come back home to regular medical duties only to find older, larger, clunkier fluid warming systems and wondered why the Thermal Angel was unavailable for civilian use.

Typical fluid warmers heat either plastic tubing sets or plastic cassettes using circulating water baths or warming plates. They need to be plugged into an AC outlet with tubing running from the wall to the patient. The nine-ounce Thermal Angel is inserted below standard IV tubing, coming from the bag and before the extension set leading to the infusion site. It takes 30 seconds to set up and warms in about 45 seconds.

"It was designed to be as close to the patient's infusion site as possible," Lopez said. "It's a single-use device that you can hook up at any point in the entire continuum of care and you can leave it there for three days of constant use."

What's also different about this fluid warming device compared with conventional fluid warmers is that the Thermal Angel directly measures the temperature of the fluid delivered to the patient and, based on the temperature, control software modifies the output of the heater flex circuit nearly 5,000 times per second to attain normothermic temperature.

"As caregivers change fluid rates or if there's a kink in the line, anything, it reads the temperature and immediately responds," he said. "Older-style machines have to build up heat in a water bath and can't react quickly. This is designed to be extremely light and quick to respond."

Lopez said one of the reasons for the recent decision to bring Thermal Angel to the mainstream is the H1N1 pandemic. Because certain patients can be at greater risk for hypothermia due to dehydration, those who receive reviving IV fluids can benefit from the addition of this temperature-stabilizing device.

In addition to emergency use, Lopez said that some healthcare providers are starting to use the device in elective dental and plastic surgeries for patient comfort since operating rooms are typically cool and patients often wake up shivering.

"Until now we have focused primarily on serving the U.S. military," he said. "We have been completely overwhelmed from all sectors of the U.S. government and chose to keep a low profile because we didn't have the capacity. But last year we worked on production capacity and tripled our output. We've got a strong steady supply and now we've been able to meet the needs of the government and we're starting to let the commercial market have it. We don't do any sales and marketing, nor do we have any sales people. Guys coming back from duty in the military have spread the word."

Lynn Yoffee, 770-361-4789;