Kennedy, Case, Hurd, Cruz, and Capstone Project

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This hard line stance coming from these medical professionals reflects the fact that these drugs have yet to be fully tested as agents for reducing transfusion related reactions, and therefore, according to the authors of the editorial, should not be used until being further evaluated.

The Geiger and Howard article (2007) takes an entirely different stance on the issue. They feel that the pretransfusion use of acetaminophen and diphenhydramine has some basis in biology, if not in clinical studies. This comes from the fact that these drugs reduce fever and the propensity for allergic reactions in patients when taken for other ailments, and that these characteristics alone serve to justify their use as a prophylaxis for similar conditions related to transfusions (Geiger and Howard, 2007). The authors believe that the toxicity of these drugs however can be a negative aspect when administered to patients who are particularly ill, and who would otherwise not likely benefit from these drugs being administered in the first place for other similar reactions or ailments. This is an interesting stance because it shows the ability for medical professionals to understand that the biology and characteristics of a drug likely present some benefit to pretransfusion patients in reducing the potential for reactions, but that the lack of clinical trial-based evidence does not specifically rule out the use of these drugs, it only suggests that they should be administered in moderation and under the best intentions and understandings of the health care professionals whose care is being provided to the patients in question.

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Within a secondary study of the fibrile nonhemolytic transfusion reactions themselves, the evidence for including the drugs acetaminophen and diphenhydramine in a pretransfusion dosage yielded results supporting the fact that these drugs help the patients more than thy could potentially hurt them, yet the administering of these drugs does not have any direct cost benefit to the healthcare provider themselves (Ezidiegwu, Lauenstein, Rosales, Kelly, and Henry, 2004). This attitude is interesting since much of the medical world relies on evidence-based change in their practices and does not condone the use of medicines or procedures for their prophylaxis exclusively.

Furthermore, authors Rosswurm and Larrabee (1999) are quick to argue that the best model for providing adequate and accurate healthcare is one that is based in evidence. This means that doctors, nurses, and other healthcare professionals should not assume that just because a practice has a history or prevalence within the medical field, that it should be followed, even with a lack of trial-based evidence. This is a profound attitude and one that should be replicated in any science-based profession or field. It is nearly impossible to justify a practice or assumption as good for a patient when there is little to no evidence stating so. Certainly a lack of evidence stating the contrary is no justification either. Healthcare professionals have the obligation and responsibility to their patients to rely on evidence-based data and understandings of drug reactions and procedures, even in the presence of prophylaxis relative to the administering of certain drugs before transfusion......

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