Escalation must follow the patient's orders and agency policy; the following are representative thresholds.
🚩 Red flags — escalate
A fall with injury — assess and escalate per severity and the agency protocol; activate emergency response (911) for a serious injury or a head strike (on anticoagulation, see the Anticoagulation overlay).
An immediately dangerous environment — no heat, a fire hazard, or unsafe oxygen near an open flame — urgent intervention and coordination.
A medication error with potential for harm — provider notification and a corrective plan.
Suspected abuse, neglect, or exploitation — mandated reporting per state law and agency policy, and safety planning.
An inability to summon help in an emergency — urgent coordination of a solution.
An elopement risk in a cognitively impaired patient — an urgent safety plan with the caregiver.