Before implementing a POCUS program, several administrative requirements should be addressed First, a point person should be identified who either is already well trained in POCUS, or is prepared to undertake additional ultrasound training This person will ultimately be responsible for the training of staff, residents, and fellows, as well as assume responsibility for quality assurance and interdepartmental communication Second, an ultrasound system should be purchased designed for the purposes of ED use Staff and trainees must be able to put what they have learned into use and only those who perform ultrasound scans routinely will gain sufficient facility to incorporate it into their practice There are now many companies that recognize the need for ED-specific machines and have products that cater to this niche Third, starting a program is best done in concert with hospital leadership and credentialing committees A collaborative relationship with Radiology is important Whenever possible, data should be employed to justify evidence-based implementation of specific POCUS examinations with the ultimate goal of improving patient care Once the lead person has been identified, teaching of the staff and trainees can commence Although there are some published standards for training in ultrasound, there is still debate among different governing bodies as to minimal requirements to achieve competency Guidelines from the American College of Radiology and the American Institute of Ultrasound in Medicine are geared toward comprehensive, diagnostic examinations and are not applicable to POCUS The AAP and ACEP have published consensus guidelines based on expert opinion and previously published data which have now become the current standard for pediatric emergency medicine In general, programs should establish a minimum number of didactic hours, a minimum number of overall ultrasound examinations, and a minimum number of examinations to look for a specific finding These requirements will form the basis of the credentialing process for staff physicians Despite these baseline requirements, literature would suggest that there continues to be an ongoing learning curve that plateaus at a significantly higher number of scans per application Equipment Considerations The ideal equipment for POCUS should have durability, mobility, good image quality, good battery life, and rapid boot-up time Most importantly, the anticipated type of ultrasound scans should guide the purchasing of equipment If a machine is being purchased for vascular access only, then one with a highquality cardiac application would not be justified There are numerous ultrasound systems that are tailored to the practice of emergency medicine and the technology is constantly advancing All machines should be portable and