Transport changes the environment, not the need for continuous support. Treat loading, elevators, vehicle transitions and handoff as parts of the same clinical mission. This guide supports planning by trained ECMO teams and is not a cannulation or circuit-priming manual.
1

Agree on the mission

Establish the clinical purpose, accepting team, destination capability, transport mode and required expertise. Confirm patient stabilization and a contingency for deterioration before movement.

QuestionDecision to make explicit
Why transfer?Higher-level support, definitive treatment or recovery pathway. Clarify what the receiving team can provide.
Who owns each task?Clinical lead, circuit management, airway, medications, patient movement, communications and receiving handoff.
What may fail?Airway, gas, power, vascular access, infusion, cannula securement or circuit function. Make the response roles clear.
What changes the plan?Clinical instability, weather, vehicle or equipment limits, route delays, unavailable bed or inadequate resources.
2

Count the whole journey

1 · At the bedsidePrepare, connect, assess and load.
2 · Between centersTravel plus all loading and unloading steps.
3 · At the destinationReach the bed and establish verified support.

Estimate power, gas and infusion endurance for the complete mission with reserve. Count the oxygenator, ventilator and other gas-dependent devices. Use verified equipment consumption and battery information rather than a generic calculator.

Readiness record: support mode and cannulation ___, current flow/gas/ventilator state ___, hemodynamics and recent gases ___, infusion inventory ___, measured reserves ___, receiving acceptance ___, contingency and contacts ___.

The clinical planning concepts are adapted from the source transport supplement. Device assembly, priming, de-airing and emergency manipulation require the specific manufacturer instructions and demonstrated team competency.

1

Pause at each transition

Before movement, verify securement, accessible monitoring, power/gas connections and the ability to reach essential equipment. After every bed or vehicle transition, reassess the patient and circuit.

CheckpointRead-back
PatientAirway, ventilation, oxygenation, perfusion, sedation, temperature and bleeding.
Cannulae and circuitPosition and securement, no tension or visible kinking, observed flow and pressures, accessible sites and alarms.
Power and gasActual source in use, connected reserve, battery status, gas delivery and remaining supply.
Medication and accessActive infusions, remaining volume, pump settings, line identification and access for emergency treatment.
CommunicationCurrent location, estimated arrival, change in condition, receiving readiness and responsibility for the next move.
2

A failure is a team event

Recognize patient deterioration and equipment failure separately, then communicate a shared priority. Trained operators use the exact device emergency procedure. Avoid a generic clamp, hand-crank, circuit-opening or de-airing sequence that may be wrong for the configuration.

3

Close the handoff with observed support

Transfer the cannulation map, current support and monitoring, blood gases, anticoagulation and bleeding context, medications, recent events and unresolved risks. Confirm responsibility and functioning support before the transport team disengages.

A transfer is complete when the receiving team has accepted responsibility and verified the patient, circuit, power, gas and infusion state at the destination bed.

Use VA-ECMO for circulation and complications, and MCS Weaning for the recovery/exit framework. Operational dispatch details and device-specific priming instructions are outside this guide.