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palliative

Noisy Breathing / Death Rattle Assessment

Assesses severity of noisy breathing (death rattle) due to retained secretions in dying patients and guides pharmacological management.

Score interpretation

Mild or absent secretions

→ Position: semi-prone or lateral; gentle oral care; reassure family; routine monitoring

Moderate noisy breathing

→ Glycopyrronium 200mcg SC PRN or via CSCI; avoid suctioning (distressing, ineffective); explain to family: patient unlikely to be distressed despite noise

Severe distressing secretions

→ Glycopyrronium 600-1200mcg/24h via CSCI; consider hyoscine hydrobromide if sedation also needed; family meeting; ensure nursing presence; crisis medication available

Interpretation bands for the Death Rattle / Secretions. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.