Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a crucial and life-preserving adjunct of care to the critically ill patient in refractory cardiogenic shock. ECMO is commonly initiated in the intensive care unit for hemodynamically unstable patients, the operating room for post-cardiotomy shock, or as extracorporeal cardiopulmonary resuscitation (ECPR) in cardiac arrest. In contrast, the cardiac catheterization laboratory (CCL) is a procedural area in which percutaneous coronary, structural heart, and electrophysiology interventions may be performed with or without surgical capabilities (i.e., hybrid operating rooms). Patients in these settings range from elective outpatient procedures to those in refractory cardiogenic shock. Access to mechanical circulatory support in the CCL to bridge or rescue patients in cardiac arrest or refractory heart failure can vary. Furthermore, CCLs are often insufficiently staffed and poorly equipped to resuscitate patients once ECMO is initiated. These patients require critical care management for ongoing resuscitation with the risk of direct patient harm if not managed appropriately.