A transfer trolley modified to include ECMO consoles.
Appropriate mattresses are required in patients with a high risk of skin damage.
Replacement equipment is required in case of unexpected failure. This should include a back-up pump, driven either electrically or manually. A spare oxygenator and circuit are necessary.
Other resuscitation equipment such as suction systems and defibrillator are required.
Adequate power and an O2 supply are required for the duration of the transfer. This means that vehicles or aircraft may need to be modified to accommodate the extra gas requirements, or be able to deliver the proper current. In vehicles, all equipment has to be secured to protect staff and patients.
When planning to cannulate and commence the ECMO in another hospital, the team needs to have enough equipment to accommodate the needs of the patient, including a variety of cannulas. All the equipment should be ready at all times, and checklists used to ensure nothing is missing.
Checklists should be available to support the team. This includes a World Health Organization insertion checklist to be used before inserting the cannula.
Care during transfer
Patient vital signs should be monitored during transfer. This includes heart rate and rhythm, blood pressure, O2 saturation, end-tidal CO2, temperature and pupil reaction.
The ECMO circuit must be monitored; this includes circuit pressure, sweep gas and pump flow monitoring. All observations should be regularly documented. Portable devices allow monitoring of blood gases and coagulation during long transfers.
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