Table 5.

Minimum implementation requirements for routine sepsis-oriented POCUS use in the emergency department.

Implementation domain	Minimum requirement for routine ED use
Framework structure	Time-boxed source-first scan plus FoCUS and LUS; PLR-LVOT VTI when Doppler skill is adequate; venous Doppler/VExUS only as optional advanced add-ons
Competency	Supervised scans with image review; emphasis on decision triggers, reliability limits, and escalation rules
Documentation	Structured note or worksheet that separates source findings, phenotype, and responsiveness/tolerance assessments; saved key clips when feasible
Quality assurance	Regular audit of image adequacy, diagnostic accuracy, escalation appropriateness, and selected workflow/process outcomes
Escalation and governance	Clear rules for CT, radiology-performed ultrasound, or formal echocardiography when uncertainty, poor image quality, or high-risk features persist

CT, computed tomography; ED, emergency department; FoCUS, focused cardiac ultrasound; LUS, lung ultrasound; LVOT, left ventricular outflow tract; PLR, passive leg raise; POCUS, point-of-care ultrasound; VExUS, venous excess ultrasound; VTI, velocity-time integral.