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| Working Drawing: Pressure Hood |
| BIOCOOL |
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If genius is the ability to see connections among seemingly unrelated things, then Bill Elkins is a genius.
Now the head of bioCool technologies, a military- and medical-device designer and manufacturer, Elkins is an engineer/entrepreneur who keeps colliding with Pressure and Temperature. He designed the first rigid-structured space suit in the world for Litton Industries. He designed flight suits that integrated pressure and temperature controls to keep fighter pilots conscious in high-speed maneuvers. He designed protective suits to keep steelworkers healthy while working near huge smelters. None of this is theoretical�since he also holds the world record for sustained G-forces (16.5 times his body weight, accomplished in a centrifuge during the Mercury space program).
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Early in his career, Elkins saw an unusual connection. Pressure and cool temperatures, which he had already used in suits for aerospace and industrial applications, were also desirable in a range of medical therapies. What if he could build a suit to mitigate the effects of disease and trauma?
"I realized I had already built some of the technologies," he says. "But they were in a whole-body system. I just had to cut it into pieces."
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INFLAMMATION
Elkins hired PTS in the late 1990s to help him solve some relatively small-scale problems with a prototype solution that used a cooler full of water, an air pump, a water pump, and a fabric splint to deliver cold water and oscillating pressures to reduce inflammation at the injury site.
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A controller pumped air through one set of channels in the splint and cooled water through another. Using this system, an inflamed injury could be cooled deeply for long periods of time without discomfort, thus greatly accelerating recovery.
"I worked with Josh Orkin (PTS's business development manager) on the prototypes, and I'm very impressed with him," says Elkins. "He's very creative and thoughtful, and his work doesn't end at the end of the day. He takes the concept home with him and lets it percolate,and then he comes up with a solution."
Orkin has similar feelings about Elkins. "He's demanding, but he's appreciative of creativity," he says. "It's very much a collaborative process with him."
STRETCHING TIME
After succeeding with the pressurized cooling splints, Elkins thought that he and PTS, working together, could address far more serious conditions. "When you cool the body, it's almost like you're stretching time, biologically," he says. "The time of cell-death is postponed; the window of potential recovery is lengthened." If he could develop a cooling hood, he could solve some of the dreadful complications of multiple sclerosis, stroke, and head-trauma.
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Working with PTS and a mannequin head they named Yorick, Elkins developed a prototype hood design that could bring cold water into intimate contact with the entire surface of a skull. And it worked on Yorick. But on skulls of a different shape, the fit was not good enough.
"The problem was that what he envisioned would not work perfectly with the materials that were available," says PTS's Orkin. "To make it fit, we had to re-think how we cut the patterns for the liner of the hood," which was where all the cooling and pressure tubing was sewn in.
"After four iterations, we came up with something that worked," Elkins confirmed. "But with all the give and take, I'd be hard put to it at this point to say "This was my idea and this was Josh's." It was a real cooperative effort."
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 | | "Yorick" in an early prototype. |
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Elkins was extremely satisfied with the prototype. "The end result worked magnificently," he says. "PTS just does fabulous work."
LIVES IMPROVED
Since developing that prototype, the hood (sometimes combined with a vest) has had significant success in the real world�success measured in terms of lives improved and even lives saved.
It has had a real impact on multiple sclerosis therapies. Elkins first got interested in MS when he observed experiments conducted at the UCLA physical therapy center. An early protocol, putting patients in 40-degree water for an hour before therapists manipulated their limbs,had hinted at the benefits.
Ten years later, Elkins saw former Olympic skier Jimmy Heuga on the Today show. Heuga, who was afflicted with MS, ran a center in Vail, Colorado that explored different MS therapies, and cooling interested him greatly.
Elkins contacted Heuga, took to Vail a prototype that included both hood and full-torso vest, and tried it on five patients. The results surprised everybody. The patients in the vest/hoods reacted positively during the one-hour exercise period. Their oxygen consumption (a measure of the amount of work required for certain exercises) went down. More important, 36 hours after the therapy, their balance, speech, vision, and strength were still improved, a major breakthrough in MS therapy. Elkins's devices are now being used on more than 1,000 patients in the US, Sweden, Canada, England, Germany, and Italy.
LIVES SAVED
The hood alone is transforming head-trauma treatment thanks to the work done by PTS and Elkins, and the initiative of Dr. John Wang, a neurosurgeon at the Order of St. Francis Hospital in Peoria, Illinois. Wang knew that a person with severe head trauma has a problem that won't wait: lack of oxygen for the brain. Once brain cells die, there is no recovery of function even if the victim is revived. Wang was on a mission: he needed a way to rapidly cool the brains of head-trauma victims,in effect, to stretch time to give them a better chance to recover.
One day, Wang read a report by Elkins about the effects of head-cooling on MS patients. "It was a "Eureka!" moment for him," says Elkins. Wang contacted him through NASA, and they started immediate development work on a head-trauma hood with Orkin at PTS.
The result of this collaboration was a prototype that fit all possible head shapes and sizes, and that rapidly cooled internal tissues without freezing (and killing) external ones. To test its effectiveness, Wang designed a head-trauma study using 20 patients at his hospital ER.
One of the first patients in the study was a 17-year-old girl who had been in a severe auto accident. "We put the hood on her, expecting that we might be able to drop the temperature of her brain 4 degrees F over four hours," Elkins recalls. The hood did far better. "We actually dropped the temperature 4 degrees F in 15 minutes, and brought it down another 11 degrees F over the next four hours." The patient recovered completely. When she resumed her interrupted career in high-school cheerleading, she demonstrated the power of rapid cooling as a trauma therapy.
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SOMETHING MEANINGFUL
Elkins has big plans for future collaboration with Precision Technical Sewing. He's been thinking a lot about Iraq.
"The troops in Iraq are now facing heat-stress for a major part of the year," he says. "My goal is to build 15,000 suits with integrated cooling systems by next summer. I'll be working with PTS on that. In fact, that will be Josh's and my first order of business in the new year."
Orkin will be happy to help. For now, however, he's glad to have been such a large part of the development process for the hood and vest; it's not every day at work that you get a chance to improve someone's life. Or save it.
"It's quite gratifying to me," Orkin says, "to have been involved in something medically significant."
The completed system, which has already
earned its stripes in trauma centers
across the country. |
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