I have been a hospice nurse almost 2 yrs now. In all that time I've never seen someone with Kussmaul resp. except once in my family member how passed last week. She had pancreatic CA with mets to the liver. I didn't even recognize that these were Kussmaul resp. until after she passed. How commonly have you other nurses seen these resp. at end of life. My family member only had liquid oxy avail that was being given q 1-2 hrs, and by the time I called hospice to demand roxanol, she had passed. The nurse knew roxanol was missing from comfort kit and was not too concerned about ordering it. My aunt did not have an allergy to roxanol. Do any of you think this would have provided more comfort? Right before she passed we gave her 15 mg oxy and lorazepam. She passed about 15-25 min later with Cheyne Stokes resp at the end. At the time I had such a hard time thinking objectively. I questioned every decision I made. The hospice that my family chose was not the one I work for and it breaks my heart to think she could have had a better death. I feel somewhat responsible.