Information required for a 1300 VECMOS referral

You will need to provide basic referral information (described below) when referring to the Victorian ECMO Service:

• Patient demographics (hospital ID details)
• Hospital admission date and time
• Patient weight
• Full set of patient observations

Once a patient is referred to the Victorian ECMO Service

A teleconference is initiated between the referring clinician and on-call Tier 1 and 2 ECMO specialists. As a result:

• Case is created in the VECMOS Clinical Information System (CIS)
• Current cardio-respiratory supports are discussed and optimised
• Need for early in person assessment by a ECMO Specialist is determined
• Eligibility for ECMO and/or retrieval to a comprehensive or intermediate centre is determined with the referring clinician
• Where a patient is referred to the VECMOS for ECMO but is assessed as: not to benefit from ECMO, a recommendation will be made to the treating hospital not to provide ECMO. In such cases, VECMOS recommendations to the referring hospital also address treatment options other than ECMO such as the benefit of inter-hospital transfer, appropriateness of ongoing active treatment and palliation. The ECMO lead or senior clinician at the referral hospital should ensure the patient, family/carer or MTDM remain involved and informed in the decision-making process.
• Where a patient is referred to the VECMOS for ECMO and is assessed as: suitable/likely to benefit from ECMO, the process of ECMO initiation will commence. The ECMO lead or senior clinician at the referral hospital should ensure the patient, family/carer or MTDM remain involved and informed in the decision-making process.
• Where patient or staff transportation is required, the ARV coordinator and hospital transport staff are included in the call.

A significant proportion of ECMO calls may require more than one teleconference, or, additional advice from speciality services including:

• heart and lung transplant physicians
• cardiothoracic surgeons
• interventional cardiologists
• respiratory physicians
• toxicologists
• Paediatric Infant Perinatal Emergency Retrieval service.

In line with the guiding principles of the Victorian ECMO Service, the aim should be to decide on ECMO eligibility within 30 minutes of a referral. The process of gathering additional information and planning for a retrieval should not take more than two hours.

Please note that ECMO for refractory cardiac arrest cannot be provided by VECMOS to sites without exisiting ECMO initiation services (Tiered sites).

Feedback from staff using the VECMO Referral Pathway (1300 VECMOS) is welcome and can be provided by email to info@vecmos.org.au