Adeath rattle is noisy breathing that often occurs in someonenear death.[1] Accumulation of fluids such assaliva andbronchial secretions in the throat and upper airways are the cause.[2] Those who are dying may lose their ability toswallow and may have increased production of bronchial secretions, resulting in such an accumulation.[3] Usually, two or three days earlier, symptoms of approaching death can be observed, such as saliva accumulating in the throat, difficulty taking even a spoonful of water,shortness of breath, and rapid chest movement. While a death rattle is a strong indication that someone is near death,[2] it can also be produced by other problems that cause interference with the swallowing reflex, such asbrain injuries.[3]
It is sometimes misinterpreted as the sound of the personchoking to death orgargling. Notably, death rattle is a separate phenomenon fromagonal respiration,ataxic respiration, andKussmaul respiration.[4]
This symptom most commonly appears sometime during the last 24 hours of the person's life, although some live somewhat longer.[5]
The dying person is usually unaware of the noisy breathing and is not disturbed by it, but some healthcare providers attempt to minimize the sound for the emotional comfort of family members and caregivers.[1] This may be done through repositioning the person, reducing the volume ofIV fluids being given, or givinganticholinergic or anti-muscarinic drugs to reduce secretions, which have side effects.[6][5]
