Escalation must follow the patient's orders and agency policy; the following are representative thresholds.
🚩 Red flags — escalate
A new acute speech change — slurred speech (dysarthria) or new word-finding or comprehension difficulty (aphasia) — possible stroke: activate emergency response (911) (detail in Neurological).
A communication barrier that prevents safe care or emergency communication — urgent arrangement of an accommodation.
An inability to communicate distress, pain, or symptoms — a safety risk requiring an augmentative strategy and close monitoring.
A consent process compromised by an unmet language or communication need — stop and arrange a qualified interpreter and confirm comprehension before proceeding.
Sensory loss (hearing or vision) that creates a safety hazard — provider notification and coordination (detail in Ears / Hearing and Eyes / Vision).
A cognitive-communication change suggesting delirium — urgent evaluation (detail in Cognitive / Mental Status).
