Decisions to transfuse should be based on assessment of an individual patient including their underlying cause of anemia. There is high quality evidence that demonstrates a lack of benefit and, in some cases, harm to patients transfused to achieve an arbitrary transfusion threshold. For hospitalized adults who are hemodynamically stable, a restrictive transfusion strategy is recommended, with transfusions potentially considered when hemoglobin falls below 70 g/L. Higher thresholds may be used for patients undergoing cardiac (75 g/L), orthopedic surgery (80 g/L), those with ongoing cardiovascular disease (80 g/L) or acute myocardial infarction (90-100g/L). For hospitalized patients with hematologic or oncologic disorders, a similar restrictive approach is recommended, using the <70 g/L threshold. In addition, for hospitalized patients without active bleeding, transfuse only one unit of red cells. Risks of red blood cell transfusions include allergic reactions, fever non-hemolytic transfusion reactions, bacterial infection, volume overload, transfusion-related acute lung injury and hemolytic reactions. Sources: Callum J, et al. Bloody easy 5, blood transfusions, blood alternatives and transfusion reactions, a guide to transfusion medicine. 5.1 ed. Toronto (ON): Sunnybrook and Women’s College Health Sciences Centre. [Internet] July 2023 [cited 2025]. Carson JL, et al. Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. 2023;330(19):1892–1902. PMID: 37824153. Pagano MB, et al. Red Cell Transfusion in Acute Myocardial Infarction: AABB International Clinical Practice Guidelines. Ann Intern Med. 2025 Oct;178(10):1469-1477. Epub 2025 Aug 19. PMID: 40825204.