Abnormal findings are charted as a chain — finding, severity, comparison to baseline, the risk it creates, and the skilled action taken.
New coughing or choking with intake, a wet or gurgly voice after swallowing, or pocketing — concerning for an unsafe swallow and aspiration risk.
Acute choking with airway obstruction — an immediate emergency.
Sudden dysphagia with slurred speech, facial droop, or weakness — concerning for stroke (route to Neurological).
Post-meal shortness of breath, a wet voice, low-grade fevers, or recurrent pneumonia — concerning for aspiration, possibly silent, and developing aspiration pneumonia (cross-reference Respiratory).
Consumption of textures more advanced than the ordered IDDSI level, or incorrectly thickened liquids — an unsafe deviation from the protective diet.
Poor positioning or unsafe feeding technique — increasing aspiration risk and requiring correction.
Significant oral residue or pocketing after swallowing — indicating impaired clearance and aspiration risk.
A significant decline in intake or unplanned weight loss from swallowing difficulty — requiring nutritional and swallow re-evaluation (route to Nutrition).
