Mobile ECMO for Covid-19 Does Not Pose Extra Risk to Transport Team

ABSTRACT

Transporting patients on ECMO is a proven safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to a regional quaternary care center. Prior to the COVID-19 pandemic, mobile ECMO teams were able to be transported without suffering adverse events. With the COVID-19, the safety of the staff and transport team adds a new layer of challenges. We conducted a retrospective study of 79 patients (median age 36 years old, 41% male) who were cannulated at an outside hospital and transported on Venovenous or Venoarterial ECMO to one of five quaternary care centers. The average distance travelled was 27 miles (SD 23 miles) and the duration of the transport was 56 minutes (SD 36 minutes) from ambulance bay to ambulance bay. The teams consisted of 1-2 physicians for cannulation and patient management, 2 critical care transport nurses and a driver or pilot. Mobile ECMO team members practiced strict ACE precautions while caring for the patient and were in standard PPE at other times. The primary mode of transportation was ground. Six patients were transported by air. There were no instances of transport related adverse events including pump failures, cannulation complications at the OSH or decannulations in transit. There were no instances of the transport team members contracting COVID-19 at 30 days after transport. By adhering to best practices and ACE precautions, patients with COVID-19 can be safely cannulated at an outside hospital and transported to a quaternary care center without increased risk to the transport team.