ECMO Air Ambulance: Coordinating a Complex Transfer

This page is written for referring clinicians, retrieval coordinators and family members researching options on someone else's behalf. It describes how Aviall supports ECMO transfer logistics. It is not a guarantee of acceptance for any specific case. Every ECMO transfer request is subject to clinical review by the retrieval and receiving teams, and to aircraft and crew availability, before a mission is confirmed.

Extracorporeal membrane oxygenation support changes almost every parameter of an aeromedical transfer. The patient is dependent on a running circuit that cannot be interrupted, the equipment has continuous power and space requirements, and the clinical team on board must be equipped to manage circuit complications mid-flight, not just standard in-flight patient monitoring.

Because of this, ECMO transfer feasibility is assessed jointly between the referring hospital's retrieval service (which typically owns the clinical decision and often provides the ECMO specialist team) and the aviation provider, which is responsible for aircraft, cabin configuration and mission logistics. Aviall's role sits firmly on the aviation side of that line. We do not make clinical acceptance decisions.

ECMO transfers typically involve a larger clinical team than a standard critical-care transfer, and cabin space planning has to account for every team member and their equipment, not just the patient.

• A retrieval or intensive-care specialist experienced in ECMO management, generally supplied by the retrieval service
• A dedicated ECMO specialist or perfusionist, depending on the retrieval service's staffing model
• One or more critical-care nurses supporting monitoring and medication management
• An aviation-side flight coordinator managing cabin layout, power distribution and ground handling

ECMO equipment has continuous power requirements that must be planned against the aircraft's power supply for the full mission duration, including ground time and any diversion contingency, not just the scheduled flight time. Oxygen supply is planned the same way, with margin built in beyond the minimum calculated requirement.

Cabin space is assessed early, because ECMO equipment, the patient stretcher, and a larger-than-usual clinical team competing for space around the patient is a genuine constraint on some airframes. Aircraft selection for an ECMO transfer is therefore led by equipment and team footprint as much as by range.

• Continuous power planning across flight time, ground handling and reasonable diversion contingency
• Oxygen supply calculated with margin above the minimum requirement for the mission duration
• Cabin layout confirmed against equipment and team footprint before an aircraft is proposed
• Ground power and equipment continuity arranged for any ground transfer segments

For clinicians and retrieval coordinators, the pathway to raise an ECMO transfer enquiry with Aviall is straightforward, and runs in parallel with, not instead of, the clinical acceptance process already underway between referring and receiving teams.

• Initial contact via the 24/7 operations line, with a summary of the transfer requirement
• Aviation feasibility assessment, aircraft, power, oxygen and cabin space against the stated equipment and team
• Coordination with the retrieval service on timing, once clinical acceptance is confirmed by the clinical teams involved
• Mission planning, aircraft, crew, ground handling and bed-to-bed logistics finalised ahead of departure