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dc.contributor.authorTwomey, Shelagh
dc.contributor.authorDowling, Maura
dc.identifier.citationTwomey, Shelagh, & Dowling, Maura. (2013). Management of death rattle at end of life. British Journal of Nursing, 22(2), 81-85. doi: 10.12968/bjon.2013.22.2.81en_IE
dc.description.abstractNoisy breathing or death rattle is a common clinical sign in the final days of life. When it occurs, the level of consciousness is usually low and it is generally assumed that patients are not distressed by it. Despite the assumption that patients are not distressed, death rattle is usually actively treated in palliative care settings through a combination of pharmacological and non-pharmacological measures. Anti-cholinergic or anti–muscarinic medications are the drugs of choice in practice, even in the absence of patient distress, despite there being no conclusive evidence to suggest that any drug is superior to placebo. In addition, a recent Cochrane review suggested that there is a lack of supporting evidence for the use of anti-cholinergics to treat death rattle (Wee and Hillier, 2010). The choice of drug is based on the various properties of the drug and the desired effects. However, treatment is focused on alleviating the perceived distress of family members rather than aimed specifically at benefiting the patient. Moreover, anti-cholinergic drugs can result in unpleasant side-effects such as urinary retention and dry mouth for patients who are probably unable to report symptoms. Recent research calls for prescribers to consider carefully why they are treating death rattle. Moreover, families need to be reassured and have it explained to them that it is unlikely that the patient is distressed and why this is the case.en_IE
dc.publisherMark Allen Healthcareen_IE
dc.relation.ispartofBritish Journal Of Nursingen
dc.subjectDeath rattleen_IE
dc.subjectNoisy breathingen_IE
dc.subjectPalliative careen_IE
dc.titleManagement of death rattle at end of lifeen_IE
dc.local.contactMaura Dowling, School Of Nursing And Midwifery, Room 415 Aras Moyola, Newcastle Road, Galway. 3833 Email:

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