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

Aspiration event — coughing/choking with a color change, new congestion, fever, or hypoxia — stop feeding, position, suction, and escalate (aspiration-pneumonia risk).

Silent aspiration signs — a respiratory change or recurrent low-grade fevers without overt coughing — escalate for a swallow evaluation.

Complete dysphagia / inability to manage secretions — escalate for an alternative-nutrition and airway plan.