Mobile teams using transport accessibility frameworks and principles can significantly improve patient access for out-of-hospital cardiac arrest (OHCA) compared to in-hospital extracorporeal cardiopulmonary resuscitation (ECPR). Pre-hospital mobile ECPR is the most effective option, but the rendezvous strategy also has potential benefits that merit further investigation.

Modeling can help optimize OHCA and ECPR services and inform clinical trial design, and these models should be tested through clinical trials.

In this study, it was assumed that OHCA occurs uniformly across the population.

The same approach could be used to adjust for local incidence rates or model the probability of arrest based on demographic factors, but we did not have incidence data at the fine spatial scale used.

The relative cost-effectiveness or system-level implications of the three service models in this study was also not considered.

For the exploratory survival analysis, a survival curve based on in-hospital ECPR data was used because such data does not exist for the other delivery models.

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