Respiratory secretions

Death rattle or respiratory secretions in the dying patient is common with a reported prevalence that ranges from 23 % to 92 % and can occur between 17- 57 hrs before death. It is thought to happen due to accumulation of respiratory secretion in the airways.

prevalence varies widely one of the most common symptom in dying patient along with pain , nausea , dyspnoea and agitation by the time it occurs the level of consciousness is usually low and gag and cough reflexes are often absent studies to ascertain the prevalence of death rattle are generally difficult to conduct

What happens - pathophysiology is not fully understood simply said it is caused by air passing through and over accumulated secretions in the hypopharynx , trachea or main bronchus in association with the inspiratory and expiratory phases of respiration various mechanisms may contribute to death rattle and it may be seen in the terminal phase of a wide variety of diseases including cancer , neurological , circulatory and pulmonary diseases factors / theories proposed to explain death rattle include -◘ increased production of airway secretions◘ inefficient elimination of the mucus ◘ cough inefficiency due to muscle weakness and poor coordination◘...