Working in collaboration with University of Arizona Medical Center’s (UAMC) extracorporeal membrane oxygenation (ECMO) team and the artificial heart program, ASTEC conducted a Mobile ICU (MOBI) transport simulation. The patient was a 44-year old male with massive anterior wall myocardial infarction in cardiogenic shock. He was placed on an intra-aortic balloon pump, ECMO and a mechanical ventilator. Triple-lumen central-venous-, right radial arterial- and left arm peripheral intravenous lines were placed and the patient was connected to monitoring leads and a pulse oximetry sensor. In the transportation exercise, ASTEC simulated an outlying hospital. The transport team, consisting of nurses from the cardiac intensive care unit (CICU) and pediatric ICU, a respiratory therapist and a perfusionist, disconnected the patient from the bedside machines and placed him on the mobile transport bed. The patient was wheeled down to the emergency room and loaded onto the awaiting ambulance. After securing the patient for transport and “transferring” him to the hospital, the patient was unloaded and carted back to ASTEC, which now simulated the CICU. In the course of the training, the battery on the ECMO pump failed. Without a backup, the perfusionist was forced to hand pump the ECMO circuit for the remainder of the transport. This MOBI transport exercise allowed us to examine important logistical and safety considerations and explore potential problems in transporting severely compromised patients.