Death Rattle

Specialties Hospice

Published

I saw a few people mention the death rattle in another thread and that got me thinking...are scopalamine patches used a lot in hospice? I know we use them a lot in "wet" near death patients on my onc unit.

Atropine 1% opthalmic drops 2-4 SL q4 works great and can dry up most secretions.

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Really????? Opthalmic gtts? Wow, never heard of that!

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We do this in sweden too, in my limited exerience they seem to work very well, cause no local discomfort, and avoid infection risks that the direct IV line gives.

Diana

We tend to put in an SC catheter (basically an IV cath inserted into the abdomen or thigh SC tissue) and we give all out meds SC through that. .
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Specializes in Med/Surg. for now.

Our "comfort kits" include Roxanol, Ativan, and Scopalamine patches (we use 1-4 prn), Ativan we use the intensol SL or the generic brand tablets crush well, mix with small amt of H2o and give SL. Works well for us...we use SQ pumps when necessary for pain management....and we have found COPD patients do better with Xanax instead of Ativan for anxiety...

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Is this what was once called clysis???

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When I worked hospice, we also gave most meds via clysis (hep lock inserted sub cu, secured w/ a Tegaderm or Opsite, meds given via sc push or infusion). It works very well, and the sites last a long time- no problems with phlebitis, risk of embolism and other complications that you have w/ IVs.

For pts that came in for adjustment of meds and then went home, this was an easy method for them to use to self-administer or for familiy members to administer their meds.

We used scope patches and sc atropine, usually 0.4mg- I forget how often the sc atropine was given, but we changed the scope patches q 72 hrs, also.

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Did I read earlier about morphine given via neb? I have no background in home health, this thread is fascinating. Tell me more about the ms/neb...we usually given morphine iv push or sometimes a gtt.

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I've given MS via neb in hospice- usually MS Elixir, 10mg per neb tx. Works well for COPD pts- eases breathing, reduces anxiety and pain.

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We use the Scope patches some, but mostly we use the Scope gel that one of our compounding Rx makes for us. It seems to work better, but it needs to be applied at least every 4 hours. Sometimes if it is really bad, we will use them together. But at that point, it is more for the families' comfort than the pt. It can get quite frightening for the family to hear it and even after educating them, it continues to upset them. It kinda goes in one ear and out the other. I can't judge as I know if my loved one was passing I would be the same way!

T

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