Escalation must follow the patient's orders and agency policy; the following are representative thresholds.
🚩 Red flags — escalate
Choking or signs of aspiration during eating or feeding — stop intake and activate emergency response (911) for airway compromise.
Enteral-tube dislodgement, or feeding with suspected misplacement — hold the feeding and obtain urgent evaluation per protocol.
Rapid significant weight loss or a severe decline in intake — provider notification for evaluation.
Signs of significant dehydration or an inability to take in fluids — urgent evaluation (detail in Hydration).
In a severely malnourished patient starting nutrition, signs concerning for refeeding (for example new weakness or edema) — provider notification and clinical caution.
New dysphagia with coughing or a wet voice during intake — hold the current texture and obtain evaluation (mechanics in Taste / Swallowing).
