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A, Image of a mobile operating room for emergency surgery (MOREs). A MOREs opens in the back to create a tent where extracorporeal membrane oxygenation (ECMO) is carried out. Two operators, one resuscitation commander, one clinical engineer, and one physician (playing the role of an assistant) undertake the main procedures inside this tent. B, Successful set-up of an operating room before patient arrival. A tent is set up before the patient's rescue. The patient was carried into the tent immediately after rescue, and ECMO was initiated. Even in public places where there are many people, MOREs can facilitate prehospital extracorporeal cardiopulmonary resuscitation while allowing privacy and security. C, ECMO for Case 1 in MOREs. Mechanical cardiopulmonary resuscitation was not possible because the patient was petite. Therefore, manual cardiopulmonary resuscitation was carried out.
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The MOREs reached a pier near the scene, and in 5 min, it was successfully set up before the patient's arrival (Fig. 1B). The emergency physician who arrived first with the rapid response car (RRC) initiated advanced cardiac life support (ACLS), and the patient was brought to the MOREs for venoarterial ECMO initiation (Fig. 1C).
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