OBJECTIVES The coronavirus disease 2019 pandemic has required that hospitals rapidly adapt workflows and processes to limit disease spread and optimize the care of critically ill children. DESIGN AND SETTING As part of our institution's coronavirus disease 2019 critical care workflow design process, we developed and conducted a number of simulation exercises, increasing in complexity, progressing to intubation wearing personal protective equipment, and culminating in activation of our difficult airway team for an airway emergency. PATIENTS AND INTERVENTIONS In situ simulations were used to identify and rework potential failure points to generate guidance for optimal airway management in coronavirus disease 2019 suspected or positive children. Subsequent to this high-realism difficult airway simulation was a real-life difficult airway event in a patient suspected of coronavirus disease 2019 less than 12 hours later, validating potential failure points and effectiveness of rapidly generated guidance. MEASUREMENTS AND MAIN RESULTS A number of potential workflow challenges were identified during tabletop and physical in situ manikin-based simulations. Experienced clinicians served as participants, debriefed, and provided feedback that was incorporated into local site clinical pathways, job aids, and suggested practices. Clinical management of an actual suspected coronavirus disease 2019 patient with difficult airway demonstrated very similar success and anticipated failure points. Following debriefing and assembly of a success/failure grid, a coronavirus disease 2019 airway bundle template was created using these simulations and clinical experiences for others to adapt to their sites. CONCLUSIONS Integration of tabletop planning, in situ simulations, and debriefing of real coronavirus disease 2019 cases can enhance planning, training, job aids, and feasible policies/procedures that address human factors, team communication, equipment choice, and patient/provider safety in the coronavirus disease 2019 pandemic era.

中文翻译：

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实时模拟指导 2019 年冠状病毒病困难气道管理的工作流程设计。

目标 2019 年冠状病毒病大流行要求医院迅速调整工作流程和流程，以限制疾病传播并优化重症儿童的护理。设计和设置作为我们机构 2019 年冠状病毒病重症监护工作流程设计过程的一部分，我们开发并进行了许多模拟练习，增加了复杂性，进行到佩戴个人防护设备的插管，并最终激活了我们的困难气道团队气道紧急情况。患者和干预措施 原位模拟被用来识别和修改潜在的故障点，为 2019 年冠状病毒病疑似或阳性儿童的最佳气道管理提供指导。在这种高度逼真的困难气道模拟之后，不到 12 小时后，一名疑似 2019 年冠状病毒病的患者发生了真实的困难气道事件，验证了快速生成的指导的潜在故障点和有效性。测量和主要结果 在基于桌面和物理原位人体模型的模拟过程中确定了许多潜在的工作流程挑战。经验丰富的临床医生作为参与者，听取汇报，并提供反馈，这些反馈被纳入当地临床路径、工作辅助和建议的实践中。对一名患有气道困难的 2019 年疑似冠状病毒病患者的临床管理显示出非常相似的成功和预期的失败点。在汇报和组装成功/失败网格之后，使用这些模拟和临床经验创建了一个冠状病毒病 2019 气道包模板，以供其他人适应他们的站点。结冠状病毒病 2019 年大流行时代。