Any of the following is acted on immediately. EMS is activated first for airway and life threats; provider and SLP notification and orders follow.
Red flags — act immediately
Acute choking with airway obstruction → perform the Heimlich / abdominal thrusts and activate EMS.
Sudden dysphagia with slurred speech, facial droop, or weakness → stroke — run BE-FAST and activate EMS (cross-reference Neurological).
Acute aspiration with respiratory distress, choking, or new hypoxia → stop feeding, clear the airway, and activate EMS.
Signs of silent aspiration or developing aspiration pneumonia — post-meal dyspnea, wet voice, recurrent infection, or low-grade fevers → hold the diet as ordered and notify urgently (cross-reference Respiratory).
Texture consumed beyond the ordered IDDSI level, or incorrectly thickened liquids → correct immediately and notify; re-teach the diet.
A significant decline in intake or unplanned weight loss from dysphagia → notify and coordinate with Nutrition and SLP.
