Background: Amidst a chaotic ECMO initiation or circuit exchange, even when centralized to a single location, timely acquisition of the required supplies may be challenging. We sought to create a comprehensive emergency ECMO Cart following a prescriptive and human factors design approach to minimize time for appropriate item retrieval.

Methods: The principle design rules were defined as: 1) the cart must securely contain all required disposable items for cannulation or exchange; 2) supplies should be intuitively grouped; 3) avoid stacking of similar items; 3) support two procedures without restocking; and 4) drawer contents readily identifiable by all end users. End users were defined as HVICU RNs, APPs, perfusionists, cardiac surgery residents, and cannulating physicians.

Results: Disposables (e.g. wires/kits, cannulas, etc) included were based on historical usage and expert feedback. Iterative mock layout optimization, led to the selection of a customized cart (Flexline, InterMetro Industries, Pa) with specified drawer depths and a “bronchoscope cabinet” for the oversized venous cannulas. Lastly, vinyl decals were designed with extensive user-feedback for each drawer handle and face.

Discussion: The resultant cart was well received and has become the primary supply resource for all ECMO procedures (Fig.1-Left). Handle numbering matches the utilization sequence, while the pastel palette visually organizes without predisposition. Large content lists and pictograms supports rapid identification of the desired drawer. Easily maneuverable, the flat top allows for sterile supply staging and opening. In transatlantic collaboration, this design has since been successfully implemented at the NHS Harefield Hospital UK as well (Fig.1-Right).