OK - I work in the OR and don't see this much - OK I don't see it at all.
Last night, my wife and I went to be with her dying uncle (taken off respirator, s/p head injury). This was both an unsettling and profound experience. I've never had the honor (yes, I consider it an honor) of being in the presence of a family member as they were dying - just being there with the family.
This wonderful gentleman had what I think was Kussmaul's respirations towards the end. I only remember it from school and studies. He had shallow breathing, progressivly got deeper, then progressively got more shallow again, skipping a breath or two, then starting the process all over again. This went on for a while (about 2 to 3 hours), then turned into "gasps" for about the last hour or so. The nurse provided a bolus of MSO4 to help calm the breathing, but didn't help much.
Does anyone have any knowledge about Kussmaul's? Is it not an acid/base imbalance? I had trouble finding a good link on the net. Is it always an end-of-life breathing pattern? Was it typical to change to gasping, rather than just decreasing in depth-of-breath until it stops?
P.S. - I do not believe that he was in pain. He passed peacefully, and the family was comforted by each other, the pastor, and knowing that he was no longer hungering for air and went to be with the Lord and his family who preceeded him in death... Bless all you nurses out there who are with families for the final moments of their loved ones - you are truly special.