The Design and Implementation of a Multidisciplinary Regional Extracorporeal Life Support Transport Team

Venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO) are effective, lifesaving interventions for refractory, severe respiratory and/or circulatory failure. Access to these therapeutic modalities is traditionally limited to tertiary and quaternary medical centers with highly trained subspecialties and substantial ECMO volumes. The Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region of the United States is a vast and largely rural area in the northwestern United States that encompasses nearly 27% of the country’s landmass. In April 2024 the University of Washington Medicine ECMO Program officially launched an ECMO Transport Team that can perform primary (remote cannulation) and secondary ECMO retrieval missions with 24/7 availability. The team is a concerted effort between the University of Washington Medical Center at Montlake, Harborview Medical Center, and Airlift Northwest. We describe the unique design of a multidisciplinary team of surgeons, intensivists, emergency physicians, ECMO specialists, flight nurses, and other support staff capable of providing ECMO services across the region and bridging significant disparities in care for the most critically ill patients. In addition, we review the education, training, and key logistic elements of the program that facilitate implementation.