Quaternary Level Transport-Converting Small Town ERs into ECMO Centers

One of the common phrases of the University of Michigan's Survival Flight utilizes to summarize our mission profile is, "Bringing the U to U."
What additional skills or equipment can tertiary level transport teams bring to a small town EDs or Critical Access Hospitals?
Do advanced ventilator maneuvers, inhaled pulmonary vasodilators and aggressive medical management have a clinical effect on critically ill patients?
Are there alternative strategies to address severe vasoplegia when standard vasopressors are at or above "max" rates?
Does point of care ultrasound have clinical impact?
Is there a point when patients are "too sick" to transport?
In this one-hour lecture, we will discuss the clinical impact of bedside resuscitation in hospital settings that are not generally equipped or staffed to implement “aggressive” critical care management.