Tier One - Comprehensive ECMO Centre (Alfred Hospital)

The Comprehensive centre care for patients on ECMO, and participates in the retrieval of ECMO patients. They offer all forms of ECMO support like heart and lung transplantation and mechanical ventricular assist devices. The tier one site accepts patients retrieved from all other hospitals including complex patients retrieved from Intermediate and Initiation centres.

Tier Two - Intermediate ECMO Centre (Royal Melbourne Hospital & Geelong Hospital)

Intermediate ECMO Centres provide care of ECMO patients from their own site and for patients referred from elsewhere (who do not require treatments only available at the Tier 1 site). Tier two sites participate in the retrieval and support service as part of the Victorian ECMO Service, and offer all forms of ECMO support. Intermediate centres have cardiac surgery capability to assist with complication management and to ensure adequate service volume.

Tier Three - (Austin Hospital, Box Hill Hospital, Monash Medical Centre and St Vincent’s Hospital)

Initiation Centres are designated to provide timely access to support for the wider population. initiation sites should be resourced to provide care for up to 48 hours whilst awaiting the VECMOS retrieval team. Patients who are not appropriate for ongoing care may not be accepted for transfer to another VECMOS site.

Other Hospitals 

Beyond these 7 hospitals, other hospitals will rarely need to initiate ECMO. Most hospitals will refer patients to a centralised referral service that will arrange assessment and ECMO initiation and retrieval if required. Over time, other hospitals will become Tier Three sites when services and staffing allow.

All hospitals commencing ECMO will communicate to ensure the best pathways for care are delivered for every patient and every patient journey promotes learning and understanding.

Ambulance Victoria 

Coordinates referrals and inter-hospital transfer of patients referred for ECMO.