The study aims to improve safety when putting a breathing tube, known as a tracheal intubation, into seriously ill children in the Intensive Care Unit (ICU). This is done by using a special digital list, called a Smart Checklist, which guides doctors and nurses. This list is part of the Electronic Health Record (EHR) system and helps the medical team avoid mistakes during the procedure.

In the study, the checklist will be used in six different pediatric ICUs. It includes three features: showing information about the patient's airway, alerting the team if the procedure might be difficult, and warning if the patient is at high risk of problems. The study will check if using this Smart Checklist reduces the number of issues during intubations.

• The study involves 6 different hospitals and uses a special list to help doctors and nurses.
• Only patients having a new breathing tube put in are part of the study; replacements of existing tubes are not included.
• The main goal is to make the procedure safer and see if the checklist helps reduce problems.