HELP......I'm having a "dumb" moment! - page 2
I feel like a total goof for having to ask this but tonight neither myself or another nurse could remember the proper term for "death rattles". It was a very high pressure night so maybe our brains... Read More
May 28, '02Do you mean Stridrorous? Stertorous? One of those? Both of those are noisy.... Stertorous is more imminent of death.
May 28, '02Coarse, audible ronchi noted. And if possible, please Yaenkeur suction the poor patient; I'd hate to "rattle" my way out of the world with mucous in the back of my throat that I couldn't clear. Yuk! :stone
May 28, '02http://www.aafp.org/afp/20020301/editorials.html
In the American Academy of Family Physicians site, the indicators of probable death within 14 days includes
Pooled oropharyngeal secretions (death rattle)
That's pretty straightforward. What bothers me is that last exhalation when you turn the expired patient. Eerie.
May 28, '02P-RN, I always warn the families about the "last breath". It is freaky though! I've seen people dead for minutes and they finally do that last exhale.
Since we are on the topic of death, I just drove by a local funeral home. Building has to be at least 100 years old. They are tearing it down to put up a bank. Wonder if the staff at the bank will be hearing any death rattles from all the ghosts that have got to be there!
May 28, '02Abnormal sounds include the absence of sound and the presence of bronchial or bronchovesicular sounds in the peripheral areas where you should hear only vesicular sounds. Possible causes for abnormalities include consolidation of secretions in the airways, compression of an airway by a mass, and the presence of a pleural effusion.
If you don't find a particular breath sound where you expect to hear it, the airway may be occluded, all or part of a lung may be collapsed (as in pneumothorax), or the patient may have a large effusion that compresses the alveoli.
Adventitious lung sounds--crackles and wheezes--are abnormal sounds heard over normal lung sounds. Crackles are discrete sounds that may resemble static or the sound made by rubbing a few strands of hair together close to your ear. Caused by atelectasis or fluid in the small airways, they may be audible on inspiration or expiration. Crackles that don't clear with coughing are more significant and may indicate pulmonary edema or fluid in the alveoli because of heart failure or acute respiratory distress syndrome. The more widespread the crackles, the more likely they're related to a serious problem.
Detection of crackles is facilitated when patients take slow, deep breaths that generate little breath sounds.
Crackles can also be described, as fine, medium, and coarse.
* You'll hear fine crackles in end inspiration or early expiration.
* Medium crackles are louder and more widespread and may sound moist.
* Coarse crackles are loud; you typically hear them in early inspiration or during expiration.
May 28, '02I have ben told by my nursing instructors that there is no "official" name for death rattle. But that doesent mean there isent one.
May 28, '02I used to work as a case managing RN in hospice. We used no official 'term' for this well known 'rattle' when death was near; rather, we'd explain to the family that the patient wasn't experiencing suffering as long as his oxygenation status was not compromised. If O2 was compromised, we ordered O2, and a scopolamine patch also helped dry the secretions, so family members were not as distressed.
Respirations at this time were also often irregular, and I found that teaching the family the meaning behind all this, worked more than the agonal/ cheynes-stokes terms. But I brought them out if they were necessary.
May 28, '02You have all been very helpful, as usual, and I did just describe what I heard as I really hated to use that term. Sounds so cold to me. Thanks a bunch, I don't feel quite so dumb now! HUGS!!!!
May 29, '02Howdy yall
From deep in the heart of texas
Is this a little morbid???????????
keep it in the short grass yall
Jun 2, '02I have only heard Death Rattle, Cheyne-stokes breathing or agonal breathing. Suction, please or sc scopolomine! Unfortunately, I've heard a lot of that! I work Oncology/ Palliative/Med-Surg.