Aspiration event — coughing/choking with color change, new congestion, fever, or hypoxia after eating — stop feeding, position, suction if needed, assess, and escalate (aspiration pneumonia risk).

Choking / airway obstruction — inability to speak/breathe — initiate airway clearance/Heimlich per protocol and activate EMS.

Severe dehydration — hypotension, tachycardia, oliguria, acute confusion — escalate; consider transfer.

Feeding-tube dislodgement or peritonitis signs (severe pain, rigidity, fever) — hold feeding, notify provider, transfer per severity.