As long as you are within the N3 network (a computer within an NHS organisation) you can refer a patient using the Hospital to Home pathway.

• In the SARF/ ECMO website, scroll to ‘ECMO PATHWAY ACCESS’ and select ‘SARF/ECMO Pathway login’.
• You will then be redirected to the log in area.
• If you have not used the pathway before you can quickly register as a user and send a referral notification.
• This notification will inform the ECMO team of your intentions to refer.
• A further referral form will need to be completed to provide further clinical details however we understand that sometimes it can take some time to find out all of the information required.
• The Clinical Information part of the Referral can be saved and updated until all the information has been entered.
• To complete the referral process the Referring Consultant should call the ECMO Centre directly.

*If you require urgent advice please call your ECMO centre directly.

The referral form will ask you to complete systems information for the patient. Don’t worry if you do not have all of this information to hand, the referral form can be printed from the pathway, so you can take this to the bedside to gather the relevant information. If you are really not sure of some aspects of the information required please refer anyway. It is better that the ECMO team are aware of your patient and as much of the information as possible.

Completing the referral notification will send an automated email to the ECMO team at the Royal Brompton Hospital so they are notified of your patient straight away. Completing the Referral: Clinical Information page will provide the ECMO team with the relevant clinical details.

To complete the referral process the Referring Consultant should call the ECMO Centre directly. Not all patients referred for ECMO will be accepted. That is a clinical decision made by the ECMO specialist in discussion with the clinical team and consultant at the referring centre team.

Typical patients will include those with reversible disease associated with one or more of:

• Severe hypoxaemia (e.g. PaO2/FiO2 < 13.3kPa)
• Severe hypercapnic acidosis (e.g. pH<7.20)
• Inability to achieve lung protective tidal volumes and pressures (tidal volume < 6 mL/Kg predicted body weight, plateau pressure < 30 cmH2O)
• Failure to improve with rescue therapies such as high frequency oscillation and prone positioning
• Significant air leak/bronchopleural fistula

Don’t worry if you are not sure, the ECMO team can provide advice. If you have a patient whom you think may be a candidate for ECMO please complete a referral notification and the clinical information. Following this you will have a conversation with a member of the ECMO team and they will advise if your patient may be a candidate for ECMO and will also provide advice on further medical management as appropriate.

*If you require urgent advice please call your ECMO centre directly.

There are dedicated FAQS on the Hospital to Home website for Patients and Families. In addition, please click here to download a family leaflet about ECMO and the service provided at Royal Brompton Hospital.