Reader response
Myron Yaster MD
Pediatric Anesthesia Article of the Day is most appropriately highlighting the 2025 American Heart Association update of Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care published in Circulation. CPR content, psychomotor skills and educational approach comprise the breadth of learning we must all embrace.
Is there an additional side to the CPR event? Yes!
Many of us are familiar with The Glaucomfleckens and find their humor to be quite disarming in our intense world of medicine. Dr. Glaucomflecken (William E. Flanary, MD) is an ophthalmologist, podcaster and comedian. His wife Kristin is a podcaster and media specialist.
In addition to the humor side of The Glaucomfleckens, Lady Glaucomflecken tells an amazing CPR story. When her husband suffered an at-home cardiac arrest she was thrust into the cardiac arrest bystander role. She ultimately successfully administered CPR. She thankfully knew the content and psychomotor skills of CPR.
Kristin Flanary has another CPR aspect upon which she places great focus. Listen to hear recounting her CPR experience (
). Her words and thoughts including “near death experience”, “children may grow up without their parent”, “there is a humanity behind the CPR event”, “cardiac arrest is a psychological life altering trauma” place an addendum to the chest compressions and rescue breathing of CPR.
From Kyle Ng, BSc., MD, CCFP (EM) (FPA), Clinical Instructor, University of British Columbia, Clinical Assistant Professor, Memorial University of Newfoundland
I just wanted to highlight this very interesting EMCRIT commentary on dual sequential defibrillation that helps in interpreting and understanding why the AHA recommends the way they did re: DSED.
The full podcast has more interesting details on other elements as well
https://emcrit.org/emcrit/2025-aha-acls-guidelines/
From Scientific American: Today in Science: Personalized mRNA vaccines will revolutionize medicine
Personalized Cancer Vaccines
At least 50 active clinical trials are well underway in the U.S., Europe and Asia using mRNA vaccines to target more than 20 types of cancer. These shots share a similar premise: to prime the immune system to recognize abnormal proteins linked to mutations in an individual’s tumor cells. One trial for a personalized vaccine against melanoma has now reached phase 3, the last step before a medicine can be approved for public use. Such vaccines could be available as early as 2028, with mRNA vaccines for other cancers to follow.
How we got here: Vaccines for cancer that use mRNA have been under development for decades. During the pandemic, researchers quickly pivoted and targeted the technology on the virus that causes COVID-19. The scientists who worked on mRNA for years knew it was safe to be administered as a vaccine and that most of the genetic information in an mRNA vaccine can stay the same no matter which disease you’re fighting. Now that the pandemic has waned, mRNA technology is being used to develop vaccines for a long list of illnesses, including malaria, flu, tuberculosis and norovirus. And cancer.
Stubborn target: Despite treatment advances, cancer remains broadly incurable and is a leading cause of death as life expectancies improve across the world. But because cancer vaccines must be personalized, the biggest challenge is scaling up their production. Some pharma companies are banking on automation and robotics to make such vaccines for large numbers of patients.
Future promise: One particularly deadly cancer type that might benefit from this type of vaccine is pancreatic. In most other cancers, tumors could have as many as 10,000 distinct proteins on the surface of their cells; you couldn’t possibly target every one using mRNA tech. But in pancreatic cancer, researchers have realized, tumors present with a smaller number of mutations, which might improve the odds of picking a suitable antigen to target. An early phase 1 trial of an mRNA vaccine showed strong results, with half of participants still in remission after treatment. A phase 2 clinical trial is already underway. “If you can teach the immune system to recognize the proteins in, say, pancreatic cancer, perhaps that could provide a blueprint” for other cancer types, says Vinod Balachandran an oncologist at Memorial Sloan Kettering Cancer Center who led the phase 1 mRNA trial against pancreatic cancer.