Pulmonary Breath Sounds: Hear a Death Rattle and more

[liveonearth]

http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html
These are fascinating, and horrifying.

Comments

[b-vainamoinen.livejournal.com]

Okay. I'm not a doctor, but if I recall correctly from my time in hospice - the "death rattle" (more genteely described as "terminal congestion") is NOT the "lungs filling up with fluid."

The person who is dying has lost the ability to clear his/her throat and the phlegm is just rattling in the back of his/her windpipe.

[liveonearth.livejournal.com]

Did you hear many such rattles?

[b-vainamoinen.livejournal.com]

I used to hear them all the time. It's very common. When you hear it in person and really take some time to listen to it -- it really DOESN'T sound like the person's "lungs are filling with fluid" at all. It just sounds like they need to clear their throat. Next time you're a bit phlematic, resist the urge to clear your throat for a while and you'll be able to make that sound also.

It freaks families out, though, and saying things like "OMGWTFBBQ!!!!!!11!!! TEH LUNGS ARE FILLING UP WITH FLUIDZ!11!!!" is, as you can imagine, not particularly helpful.

Families often request suction and nursing staff (who just love to do something rather than do nothing) are often happy to oblige, but all suction does is irritate the inside of the patient' throat - causing more mucous production and (ta-da!) MORE DRAMATIC DEATH RATTLE!

The hospice I used to work for used scopolamine patches for patients who were in their last 72 hours of life. That cleared up the congestion and calmed the families down A LOT.

http://en.wikipedia.org/wiki/Scopolamine

[liveonearth.livejournal.com]

Thanks for that. I had no idea scopolamine has so many uses. Wiki lists it as an anti-sialogogue, pupil dilator, anti-emetic (most common use), anti-nausea drug and analgesic, among others.

[b-vainamoinen.livejournal.com]

I should also mention that Terminal Congestion can also be silenced by changing the patient's position slightly. Any decent hospice nurse is well-versed in the technique of positioning a pillow under one of the patient's shoulders in such a way that the "death rattle" sound stops. (another piece of evidence against the "lungs filling with fluid" hypothesis).