{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:10:47Z","timestamp":1793754647358,"version":"4.6.1"},"reference-count":12,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"unspecified","delay-in-days":221,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1049023X26109017_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Pediatric patients present distinct developmental, psychosocial, and clinical challenges during high-consequence infectious disease (HCID) transport. Despite these differences, national biocontainment transport systems have historically been designed around adult patients, resulting in limited pediatric-specific guidance and operational experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109017_as2\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of this study was to describe pediatric-specific observations from the inaugural deployment of the US Department of Health and Human Services\u2019 (HHS) Portable Biocontainment Unit (PBCU) during a national full-scale exercise and to identify considerations relevant to pediatric-inclusive HCID transport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109017_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A qualitative, observational evaluation was conducted during the 2025 Tranquil Passport Full-Scale Exercise. Data sources included structured interviews with pediatric actors and caregivers, evaluator observations, and facilitated multi-disciplinary debriefings. Pediatric participants simulated biocontainment transport scenarios within the PBCU across multiple sites and phases of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109017_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Pediatric transport within the PBCU required advance planning to address developmental, psychosocial, and physiologic needs distinct from adult care. Pediatric participants frequently described confusion or anxiety related to noise, vibration, movement, and the appearance of personnel in personal protective equipment (PPE). Communication challenges associated with masked voices were reported. Caregiver separation due to infection-control requirements was consistently described as stressful. Clinical teams identified benefits of pediatric-specific medication dosing guides and essential medication sets within the confined biocontainment environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109017_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This inaugural deployment of the PBCU with pediatric participants identified key operational and psychosocial considerations relevant to pediatric-inclusive HCID transport. Findings supported the need for deliberate integration of pediatric-specific planning, communication strategies, and resources within biocontainment transport systems. These observations may also inform pediatric HCID transport planning in international settings where similar challenges are encountered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1049023x26109017","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:59:28Z","timestamp":1786348768000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Pediatric-Inclusive Biocontainment Transport Model: Evaluation of the US Portable Biocontainment Unit during the Tranquil Passport Exercise"],"prefix":"10.1017","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-2452","authenticated-orcid":false,"given":"Tress","family":"Goodwin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00y4zzh67","id-type":"ROR","asserted-by":"publisher"}],"name":"The George Washington University School of Medicine and Health Sciences"},{"id":[{"id":"https:\/\/ror.org\/03wa2q724","id-type":"ROR","asserted-by":"publisher"}],"name":"Children\u2019s National Hospital Department of Emergency Medicine and Trauma Service"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Walther","sequence":"additional","affiliation":[{"name":"Administration for Strategic Preparedness and Response"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tschuna","family":"Patterson","sequence":"additional","affiliation":[{"name":"Administration for Strategic Preparedness and Response"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Lowe","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Lamana","sequence":"additional","affiliation":[{"name":"Administration for Strategic Preparedness and Response"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"S1049023X26109017_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000750"},{"key":"S1049023X26109017_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.sempedsurg.2022.151219"},{"key":"S1049023X26109017_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2024.03.003"},{"key":"S1049023X26109017_ref9","unstructured":"9. US Department of Health and Human Services, Administration for Strategic Preparedness and Response. ASPR Portable Biocontainment Unit Factsheet. https:\/\/aspr.hhs.gov\/Tranquil-Passport\/Documents\/ASPR-Portable-Biocontainment-Unit-Factsheet.pdf. Accessed June 11, 2026."},{"key":"S1049023X26109017_ref1","unstructured":"1. Administration for Strategic Preparedness and Response (ASPR) - Technical Resources, Assistance Center, and Information Exchange (TRACIE). EMS Infectious Disease Playbook. US Department of Health and Human Services; 2023. https:\/\/files.asprtracie.hhs.gov\/documents\/aspr-tracie-transport-playbook-508.pdf. Accessed June 11, 2026."},{"key":"S1049023X26109017_ref8","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2025.2519538"},{"key":"S1049023X26109017_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-77032-1_10"},{"key":"S1049023X26109017_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2024.01.014"},{"key":"S1049023X26109017_ref7","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2018.0074"},{"key":"S1049023X26109017_ref10","unstructured":"10. US Department of Health and Human Services, Administration for Strategic Preparedness and Response. ASPR kicks off Tranquil Passport exercise to test new Portable Biocontainment Unit and healthcare system\u2019s ability to isolate and treat high-consequence infectious disease patients. News release. https:\/\/aspr.hhs.gov\/newsroom\/Pages\/Tranquil-Passport-Exercise-Kickoff-25June2025.aspx. Accessed June 11, 2026."},{"key":"S1049023X26109017_ref11","unstructured":"11. National Emerging Special Pathogens Training and Education Center. Tranquil Passport: testing the nation\u2019s special pathogen readiness ahead of the FIFA World Cup. NETEC News & Blog. https:\/\/netec.org\/2025\/07\/02\/tranquil-passport-testing-the-nations-special-pathogen-readiness-ahead-of-the-fifa-world-cup\/. Accessed June 11, 2026."},{"key":"S1049023X26109017_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/10497323231167348"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X26109017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:59:30Z","timestamp":1786348770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X26109017\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1049023X26109017"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x26109017","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e18"}}