Saturday March 1, 2008
Palliative care - Death Rattle

Patients at end of life process, lose their ability to clear oral secretions. As air moves over the secretions, which have pooled in the respiratory tract, the resulting turbulence produces noisy ventilation, call Death rattle.

One easy bedside tip is to use 1% Atropine ophthalmic drops sublingually. Time of onset for action is about 30 minutes. It can be given every 2 hours PRN.

Other treatments are scopolamine patch placed behind the ear once every three days, Benadryl 25-100mg every 4 to 6 hours PRN or Robinul (glycopyrrolate) - 400 mcg SC every 8 hours PRN.