Death rattle

A sign that accompanies impending death.


Death rattle prevalence ranges from 12–92%.


It suggests an impending death within three days.


It is caused by the sound of secretions and muscle relaxation  in the upper airway.



Death rattle probably does not affect patients, as they generally have reduced consciousness in this final phase of life.



Individuals that observe rattling breath sounds find it stressful and disturbing as they conclude that patient is experiencing harm or choking.



Management of patients undergoing a death rattle consists of repositioning the patient to produce more comfort, as well as informing observers of the nature of the process.



Placebo controlled studies found no evidence that there is a beneficial effect of anti-cholinergic treatment.



Anticholinergic agents can decrease the production of mucus, but do not affect existing mucus.



In a randomized clinical trial of dying patients, 13% of patients treated with subcutaneous scopolamine butylbromide and 27 percent of patients in a placebo group experienced a death rattle.




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