1. How do you do? John Rutherford, Dumfries

2. Or, are you any good doc? Inputs Qualifications Courses Staffing Equipment Protocols Resuscitation training Outcomes Mortality Complications Logbooks Success at techniques Satisfaction surveys

3. Success at techniques You can record a yes/no for some events Intubated or unable, caudal inserted or not This can give a percentage result We cannot be perfect How much failure is acceptable?

4. Cusum Statistical technique Move along graph to right each time you do a technique Move up if fail Move down if succeed Upper and lower limits depend on acceptable and unacceptable failure rates

5. The technical bits… p 0 acceptable failure rate p 1 unacceptable failure rate  type 1 error  type 2 error ln, log e h0= -b/(P+Q) H1= -a/(P+Q) a = ln[(1-  )/  ] b = ln[(1-  )/  ] P = ln[p 1 /p 0 ] Q = ln[(1-p 0 )/(1-p 1 )] s = Q/(P+Q)