I´m writing this from Sweden so please excuse my sometimes broken English..
I really need your opinion on this:
A couple of years ago my beloved Mother who lived in a nursing home since she had her stroke 15 years earlier, died.
She got pneumonia and didn´t respond to the antibiotics they gave her.
I feel a tremendous guilt over her passing.
The last evening she got this rapid breathing, and when I sat down by her bedside at 12 that night it had gotten worse, deep and fast, up to 50 breathes per minute I think.
She was totally alerte and awake though.
After an hour or so I rang the nurse, she came and gave her an injection of 7.5 mg Morphine-scopolamine plus 5 mg Stesolide( sorry don´t know the names of these meds in English).
I think when I look back that it helped a little, but the breathing was still very fast and deep.
I felt so helpless and it was so hard watching her breath like that and I rang the bell again 30 minutes later.
I blame myself so much for this..I asked the nurse if she could have a little more since the breathing was still heavy.The nurse said yes and gave her another injection of what I later understood was the same dosis.
Two hours later my Mom was dead.
When I later ask for her medical journal, the last dosis wasn´t there! They hade erased it and this can only be interpreted as they had made a mistake.
I blame myself for not fully understanding the side effects of Morphine and I knew that it had to be 4 hours between the doses, but I guess I panicked.
I would be so grateful for any comment or opinion on this.
Kussmaul respirations continue as long as the patient is acidotic ... it's the body's way of correcting the imbalance by blowing off carbonic acid. I see it most often in people dying of end-stage renal failure. Morphine does not affect it. But try breathing that hard and fast for even a few minutes ... ouch!
Thank you, heron.But the carbonic acid don't get lower when you are end-stage, right? Isn't the oxygen getting lower and lower until you die because the organs shut down?
For how long can they continue to breath that fast?!
Thank you, heron.But the carbonic acid don't get lower when you are end-stage, right? Isn't the oxygen getting lower and lower until you die because the organs shut down?
For how long can they continue to breath that fast?!
There's no one size fits all answer to that ... it takes the time that it takes and depends on the underlying disease process(es). I was trying to explain one reason that morphine would have no effect on respiratory rate. The rapid deep respiration of metabolic acidosis have nothing to do with oxygenation, so oxygen levels would not necessarily drop or be the mechanism by which the person dies. In my hospice years, I saw several people who spent days breathing this way when they were actively dying.
There's really not enough information to say for sure why your mother was breathing the way you describe or what the rationale might be for the nurses' medication decisions.
I guess I'm getting confused as to what exactly you are concerned about. Are you worried that the final dose of morphine hastened her death?
I don't know if you are a nurse or not. Morphine is not only given for pain but it is also given in hospice/comfort care to slow down the breathing and makes the breathing more comfortable, the breathing depression. A respiration rate of 50 is not a good thing as others have told you. The scopolamine is medication used at this time to decrease secretions. With her pneumonia and at this stage of the dying process, this is very normal too. The stesolide is an anti-anxiety which also helps ease the breathing and any agitation over the difficulty to breath. These are all normal. They do not hasten death. They help the patient to breathe easier and to decrease secretions that may also happen. This allows the patient to die with less pain and discomfort due to these things.
I have seen patients where they are awake, yet die a few hours later. The process is different for each person, yet there are many similarities.
No, I'm not a nurse.Yes, I've read that it is given for breathing difficulties.
I saw that she got a little calmer after the first injection and it eased the breathing a little but the rate was just the same.
I was so afraid and her breathing scared me so and I thought that maybe she needed some more.I did not understand that it could cause a breathing depression in the meaning that the patient could just stop breathing.
She did not have secretations, only a loud and noisy tachypnea, her chest was moving in and out very fast.
KarinBe
12 Posts
I also did not know that morphine could cause breathing depression.The nurse did not inform me:(