A requisition for crossmatch and immediate issue of two units of PRBCs for an adult inpatient is received. The patient’s Hgb is 120 g/L with no active hemorrhage documented. What is the most appropriate response?

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Transfusion decisions should be driven by clinical status and appropriate thresholds, not by a single lab value alone. A hemoglobin of 120 g/L (about 12 g/dL) in an adult inpatient with no active bleeding does not justify transfusion, since stable patients typically do not require RBC transfusion at this level. Giving two units now would expose the patient to transfusion risks and use blood bank resources unnecessarily.

The best move is to contact the treating physician to confirm the indication for transfusion and ensure there is a clear, evidence-based rationale. If the physician determines a transfusion is truly indicated (for example, symptomatic anemia or a specific clinical need), then proceed. If not, hold and reassess.

Transfusing based on occult bleeding isn’t supported by evidence here, and holding for 24 hours to recheck Hb would delay care that isn’t indicated at this Hb level. Proceeding with crossmatch and immediate issue without justification would be inappropriate.