Life Line has long been known for its ability to design and build custom ambulances, including highly complicated critical care units. With many specialized ambulances to its credit, the team has built neonatal ambulances, MedFlight units, and other specialty vehicles for hospitals and healthcare organizations around the country. That’s why it makes sense that, when the Center for Resuscitation Medicine at the University of Minnesota approached them for an ECMO ambulance that was unlike anything else on the road, Life Line was intrigued.
Individuals suffering cardiac arrest typically have a low survival rate. But when a physician with the Center for Resuscitation Medicine began bypassing the emergency room and instead took patients directly to the catheterization laboratory, putting them on an Extracorporeal Membrane Oxygenation (ECMO) machine, something astounding happened. The traditional survival rate jumped from approximately seven percent to more than 40 percent.
Bringing the Emergency Room to the Patient
ECMO has proven to be a life-saving technology for people suffering cardiac arrest. When a patient is put on an ECMO machine, their blood is pumped outside of the body, where the machine removes carbon dioxide and sends oxygen-filled blood back to tissues in the body. It’s incredible technology that dramatically increases the odds of survival. However, time is of the essence, and the sooner a patient is put on an ECMO machine the higher the likelihood of a positive outcome.
In 2018 the Center for Resuscitation Medicine was approached with a unique proposition by the Helmsley Charitable Trust. The Trust essentially asked them, “if your wildest dreams could come true, what would give you the greatest impact on your patients?” The answer was clear: a mobile ECMO unit. They believed if they could just take the operating room to the patient, rather than other way around, it would be transformational in increasing patient survival rates. The Trust provided the funding to make this a reality.
However, even with the vision and funding secured, building an ECMO ambulance wouldn’t be easy. The Center for Resuscitation Medicine knew this would be a prototype ambulance, the first step in bringing their vision of making ECMO more accessible to cardiac arrest patients and potentially having more ECMO ambulances strategically located around the state of Minnesota to life. In fact, the University was turned down by multiple manufacturers of emergency vehicles, companies that either didn’t have the ability or interest in building a custom ambulance of this size and scope…until they contacted Life Line.
Size and Weight of ECMO Ambulance No Problem for Life Line
Although the University of Minnesota’s ECMO unit was significantly larger than a standard ambulance, Life Line was up for the challenge. It would be the longest and heaviest ambulance they had ever built, but they were confident they could do it right.
Through their experience with critical care ambulances, particularly the Children’s Minnesota Neonatal ambulance, the engineers at Life Line knew the most important aspect of the entire process was sitting down with the team from the University of Minnesota to truly understand the mission. Would the vehicle be moving or stationary while EMS personnel treated the patient? What equipment and processes were necessary to save these lives?
Once that was understood, Life Line could begin to design the vehicle around the equipment. Life Line knew it had to make provisions for the x-ray machine, the ultrasound, the patient table and how to get a cot up to the correct level. The ambulance also needed to be equipped with a fluoroscopy machine that would ensure a proper connection of the ECMO equipment, and a unique, highly technological telepresence system that would allow a doctor to monitor the patient in real-time and direct the personnel on what to do. With all these special considerations, the ECMO unit would be twice as long and twice as heavy as a typical ambulance.
While the University of Minnesota’s ECMO unit is a prototype, the results are so promising that more communities will be looking into these life-saving units in the coming years.
If you’re considering an ECMO ambulance, here are some tips to ensure the process runs as smoothly as possible.
- Have a complete understanding of the mission and equipment
This includes everything from where the patient will be treated (in transit or parked) as well as what equipment is required. You’ll also need to account for the generators to power the equipment and back-up power supplies. Space and weight are at a premium in an ambulance, so there is no room to forget anything.
- Understand that it will take significantly longer to build
The typical production time for a custom ambulance is around 140 days. However, an ECMO ambulance is significantly larger and more complex. It can take up to four times longer to complete once a work order has been secured.
- You must be willing to work hand-in-hand with the manufacturer
Due to the highly specialized nature of an ECMO ambulance, teams from Life Line and the Center for Resuscitation Medicine at the University of Minnesota originally planned to meet every two weeks to review production progress and address issues and questions. Although COVID-19 interrupted and complicated this schedule, the teams still kept in frequent video communication and met in person whenever possible.
- You need a manufacturer experienced and comfortable with custom-built ambulances
There are no off-the-shelf ECMO ambulances. They must be custom-built to meet the specific needs of each healthcare provider. Due to their length, weight, and specialized equipment, you need a manufacturer with the skill, best practices, and commitment to customer service to truly partner with you throughout the entire process.
Building an ECMO ambulance is an involved process, but its ability to save lives makes it well worth the effort. If you have any questions about our process or capabilities, please let us know.