🔹 Objectives
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Understand ECMO transport as a process, not a single event.
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Explore requirements, team composition, protocols, and challenges of mobile ECMO.
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Emphasize training, simulation, and governance as key components.
🔹 Challenges in Mobile ECMO
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Lack of Level 1 evidence or RCTs for ECMO transport practices.
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Significant variability in global practices due to geography, resources, and healthcare systems.
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Most available data are retrospective cohort studies with inconsistent definitions and outcomes.
🔹 Mission Phases (“Anatomy of the Mission”)
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T1: Referral to Acceptance – Decision to accept or reject the case.
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T2: Acceptance to Team Mobilization – Preparing the team and transport.
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Transport to Bedside – Includes unexpected delays, location challenges.
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On-Site Assessment & Cannulation – May alter original decision (ECMO/no ECMO/transport without ECMO).
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Post-Cannulation to Return – Loading patient, returning to ECMO center, initiating care.
🔹 Setting Up a Mobile ECMO Program
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Start only after establishing a mature in-house ECMO service.
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Build a well-coordinated team with clear protocols and simulation training.
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Begin with VV ECMO cases, avoid complex VA ECMO early on.
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Prefer OR-based cannulation for early safety and standardization.
🔹 Team Composition Considerations
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Skillful cannulator (surgeon or ICU physician).
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Perfusionist or ECMO-trained nurse to run the circuit.
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Airway and infusion management personnel (ICU nurse/doctor).
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Optimize team size (usually 4–5 members), depending on mission.
🔹 Logistics & Governance
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Use standardized checklists for equipment, patient prep, transport.
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Ensure adequate oxygen supply, compatible power systems, and transport safety.
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Establish referral criteria, kit contents, and team roles clearly.
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Implement clinical governance, quality metrics, and regular debriefings.
🔹 Simulation & Team Training
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Continuous training using simulation scenarios.
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Regular M&M meetings, reflections, and process evaluations.
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Train team to adapt to unfamiliar environments and handle crises.
🔹 Key Takeaways
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Mobile ECMO is complex, multidisciplinary, and resource-intensive.
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Start small, build solid foundations, and scale up cautiously.
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Look after your team: fatigue, psychological well-being, and debriefing are essential.
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Use simulation as a core strategy for preparation and skill retention.