Question

A 70-year-old man with terminal pancreatic cancer develops noisy respiratory secretions (death rattle) in the last hours of life. He is unconscious and not distressed. His family find the noise upsetting. What is the most appropriate management?

Accepted Answer

Reposition the patient and consider an anticholinergic such as subcutaneous Glycopyrronium

Answer

Perform deep suctioning of the airway repeatedly

Answer

Intubate and ventilate to protect the airway

Answer

Give high-dose opioids to suppress secretions

Answer

Do nothing and refuse to explain to the family

Practice question

A 70-year-old man with terminal pancreatic cancer develops noisy respiratory secretions (death rattle) in the last hours of life. He is unconscious and not distressed. His family find the noise upsetting. What is the most appropriate management?