{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:22:54Z","timestamp":1785421374075,"version":"3.56.0"},"reference-count":55,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":334,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1935789325102607_sec1\" sec-type=\"intro\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Children are uniquely vulnerable to chemical, biological, radiological, and nuclear (CBRN) events due to anatomical, physiological, and psychological differences. Current decontamination practices are adapted from adult protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102607_sec2\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate current practices, challenges, and special considerations in pediatric decontamination during CBRN events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102607_sec3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A scoping review was conducted using six databases in accordance with PRISMA-ScR framework. Studies were eligible if they evaluated decontamination methods involving children (0-18 years) in real or simulated CBRN scenarios. Fourteen studies met the inclusion criteria, and data were thematically analyzed into four domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102607_sec4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Disrobing is widely recognized as a critical first step in the decontamination process, and 43% of the studies reviewed identified it as such. When done immediately and appropriately, it can remove a significant amount of contaminants. Although its effectiveness varies based on how much of the body is covered and the nature of the exposure. Dry decontamination was discussed in 21% of studies, and wet decontamination was the most commonly reported approach, appearing in 93%. Key pediatric challenges included hypothermia, psychological distress, separation from caregivers, and difficulties managing non-ambulatory or special needs populations. Few studies addressed age-specific protocols or long-term psychological impacts. The results are presented in procedural order to reflect the typical sequence of decontamination in CBRN response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789325102607_sec5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current decontamination guidelines inadequately address pediatric-specific needs. There is a critical need for standardized, age-appropriate guidelines that integrate caregiver support and psychosocial considerations. A pediatric decontamination algorithm was developed to consolidate current evidence into a practical framework for CBRN mass casualty incidents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2025.10260","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T09:51:13Z","timestamp":1764582673000},"source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Decontamination Considerations in CBRN Events: A Scoping Review"],"prefix":"10.1017","volume":"19","author":[{"given":"Eman","family":"Alshaikh","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"},{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"},{"id":[{"id":"https:\/\/ror.org\/01dcrt245","id-type":"ROR","asserted-by":"publisher"}],"name":"Rashid Hospital Trauma Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Issa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"},{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6174-0289","authenticated-orcid":false,"given":"Attila J.","family":"Hertelendy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri","family":"Davis","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"},{"name":"Florida State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2212-6969","authenticated-orcid":false,"given":"Jamla","family":"Rizek","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"DiGregorio","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8277-2570","authenticated-orcid":false,"given":"Ejemai Amaize","family":"Eboreime","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01e6qks80","id-type":"ROR","asserted-by":"publisher"}],"name":"Dalhousie University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Kung","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0160cpw27","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Voskanyan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ciottone","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04drvxt59","id-type":"ROR","asserted-by":"publisher"}],"name":"Beth Israel Deaconess Medical Center"},{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"S1935789325102607_r29","unstructured":"29. 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