This referral pathway is for staff seeking advice on patient suitability for ECMO and/or alternative management options for unwell and at risk patients.

Please note that earlier referral provides the best chance of successful ECMO.

(See Safer Care Victoria: Implementing they Victorian ECMO Service Recommendations, appendix 3.2 for further explanation)

Who can make a referral?

Hospitals without an ECMO initiation service:

Where time permits, patients with severe forms of respiratory or cardiac failure considered for ECMO support, should be seen by the most senior medical staff on duty prior to a 1300VECMOS referral who is generally best placed to make the referral. Where time does not permit additional local consultation, the Victorian ECMO Service will accept referrals from any clinical staff. The possibility of ECMO support and patient retrieval should be communicated to the patient, family/carer, or next-of-kin as soon as possible by duty staff.

Hospitals with an ECMO initiation service (Tier 3 Hospitals)

Patients that meet referral or initiation criteria at sites with ECMO initiation capability are first brought to the attention of the hospital ECMO lead or delegate. The use of ECMO support in this setting is determined by the ECMO lead in conjunction with local medical staff and with respect for the wishes of the patient. For all patients, where time permits, referral via 1300VECMOS by the ECMO lead, prior to ECMO initiation, is strongly encouraged. ECMO referral following emergency initiation of ECMO also occur via 1300VECMOS. (All patients commenced on ECMO at Tier 3 sites must be referred.)

Hospitals with ECMO initiation and maintenance services (Tier 2 Hospitals)

Patients that meet referral or initiation criteria at sites with ECMO initiation capability are first brought to the attention of the hospital ECMO lead or delegate (generally best placed to make any required referral). The use of ECMO support in this setting is determined by the ECMO lead in conjunction other local medical staff and respect for the wishes of the patient. Where time permits, referrals via 1300VECMOS prior to ECMO initiation are strongly encouraged for cases likely to required cardiac support beyond ECMO or isolated respiratory failure cases. ECMO referral following initiation of ECMO is not mandatory at Tier 2 sites, provided VECMOS Clinical Information System (VECMOS CIS) data is entered.

What is the VECMOS CIS?

The Victorian Extracorporeal Membrane Oxygenation Service Clinical Information System (VECMOS CIS) is a real time, web based clinical information system that captures all the relevant referrals, cannulation and management information for each patient referred to VECMOS.

The VECMOS CIS provides invaluable data and stores it all securely in one place.

The system integration with Adult Retrieval Victoria (ARV) allows seamless activation, coordination and management of patients that require transfer to a larger ECMO centre.