Patient referrals assessed as requiring inter-hospital retrieval or staff transportation by the ECMO Specialist on-call, are referred to the Adult Retrieval Victoria (ARV) Co-ordinator on-call (included in the teleconference) by the RASO.  

Patients should always be retrieved to a comprehensive or intermediate centre as these hospitals are capable of managing an ECMO patient throughout their treatment pathway. The principle is that patients are moved only once to the hospital able to provide the care they require.

If it is determined that a patient is stable for retrieval not on ECMO the standard ARV team will be dispatched.

For patients who are likely to require ECMO prior to transport or for who it would be safer to move on ECMO, the ECMO retrieval team will be dispatched. The ECMO retrieval team will consist of the standard ARV retrieval team with the addition of ECMO specific team members.

All staff transporting a patient in an ambulance need to have completed the ARV credentialing.

Where urgent cannulation is not required prior to retrieval from an initiation site, including most VA ECMO patients, cannulation should be undertaken with the ECMO retrieval team present.

Cannulation in the presence of the ECMO retrieval team provides many benefits. In the initial phases of the service, it is expected that ECMO volumes will remain low. Exposure to cannulations at initiation sites for individual clinicians will remain minimal. The presence of the ECMO retrieval team will increase the quality and safety for these infrequent events.

Depending on bed availability and the needs of the patient, it may be possible to preferentially direct patients to the home hospital of the retrieval team. This will support continuity of care for the patient and family members.