A 90-year-old woman in a care home has end-stage dementia. She develops respiratory tract secretions ('death rattle') in the last hours of life. She i...

Question

A 90-year-old woman in a care home has end-stage dementia. She develops respiratory tract secretions ('death rattle') in the last hours of life. She is not distressed but her family is upset by the noise. What is the MOST appropriate management?

Accepted Answer

Explain the cause to the family, reposition the patient, and consider Glycopyrronium bromide 200 micrograms subcutaneously

Answer

Suction the oropharynx vigorously every 15 minutes

Answer

Start intravenous antibiotics for chest infection

Answer

Increase the rate of IV fluids to thin the secretions

Answer

No action is needed as the patient is dying

uk-dgm MCQ (SBA): Death Rattle - End of Life Secretion Management

A 90-year-old woman in a care home has end-stage dementia. She develops respiratory tract secretions ('death rattle') in the last hours of life. She is not distressed but her family is upset by the noise. What is the MOST appropriate management?