New focal deficit / positive BE-FAST (facial droop, arm drift, speech change, vision loss) — activate the stroke/transfer pathway; document time last-known-well (time-critical, especially on anticoagulation).

Acute change in consciousness — a sudden decline in alertness, unresponsiveness, or a severe new headache — emergency evaluation/transfer.

Status epilepticus — a seizure lasting beyond the protocol threshold or repeated seizures without recovery — emergency protocol and transfer.

Aspiration event after a stroke — coughing/choking with color change, congestion, fever, or hypoxia — assess, position, suction, and escalate.