1 RBC unit is requested for a 55-year-old male with a history of acute coronary syndrome presenting with chest pain who was found to have a Hb level of 7.9 g/dL. True or false: the order for the RBC transfusion is appropriate.
This order is appropriate. The patient is symptomatic and has a Hb less than 8 g/dL. Although an acute MI has to be ruled out, it is possible that his anemia contributes to his acute chest pain and that the patient may benefit from the RBC transfusion.
2 RBC units are requested for a 65-year-old female with a history of mitral valve regurgitation scheduled to have elective mitral valve replacement replacement who was found to have a Hb level of 7.5 g/dL.
More information is needed. In a non-acute setting, for elective surgeries, anemia should be investigated and treated. If the surgery cannot be postponed, patient can be transfused one unit. There is no need to transfuse two units pre-operatively, however, she might need more units during the surgery.
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