Scott, I review all transfusion records myself. When there is an outlier for any reason (rise or drop in BP, temp spike, heartrate increase, etc.) I route a copy of the record to the nursing part of the equation that delves into these aspects described by the "solid numbers". Upon chart review the documentation either explains the reason or not. Either way the information is reviewed at transfusion committee and any followup with nursing regarding the outliers is addressed as well. Inspectors seem to be fine with it (and they have dug into it on several occassions). As with everything inspection wise it is subject to inspector interpretation to some degree.