What are the causes? The death rattle happens because the person can no longer remove secretions, such as saliva and phlegm, from the back of the throat. People normally clear these secretions without any trouble, but a person nearing death may not have the strength.
Terminal respiratory secretions occur as the body's breathing slows. This typically lasts no more than a few hours, but each patient is different and it can continue for as long as 24-48 hours. While the sound is difficult for family members to hear, it does not cause the patient pain or distress.
The “wet” or “gurgling” sounds are caused by air passing over pooled oral and respiratory secretions the patient is no longer able to swallow or cough up – the patient may still be fully or partially conscious or unconscious. Wet breathing sounds can occur on inhalation or exhalation.
Death rattle is a common symptom in the dying phase which is caused by an accumulation of secretions in the upper airway [1]. This accumulation of fluid (mucus) cannot be easily coughed up or swallowed by the patient, often as a result of a diminished consciousness.
Breathing may become irregular. Confusion and sleepiness may occur in the last hours. Secretions in the throat or the relaxing of the throat muscles can lead to noisy breathing, sometimes called the death rattle. Repositioning the person, limiting fluid intake, or using drugs to dry secretions can minimize the noise.
Pulse and heartbeat are irregular or hard to feel or hear. Body temperature drops. Skin on their knees, feet, and hands turns a mottled bluish-purple (often in the last 24 hours) Breathing is interrupted by gasping and slows until it stops entirely.
Many people lose consciousness near the end of life. But they may still have some awareness of other people in the room. They may be able to hear what's being said or feel someone holding their hand.
Visions and Hallucinations
Visual or auditory hallucinations are often part of the dying experience. The appearance of family members or loved ones who have died is common. These visions are considered normal. The dying may turn their focus to “another world” and talk to people or see things that others do not see.
The "death rattle" is a gurgling sound you may hear when people die. Since they can no longer swallow or cough, saliva builds up in the back of the throat and upper airways. The fluid causes a rattling sound when air passes through.
This pattern or respirations is known as Cheyne-Stokes breathing, named for the person who first described it, and usually indicates that death is very close (minutes to hours).
Agonal breathing is sometimes confused with a different phenomenon referred to as “death rattle.” Death rattle is more of a gurgling noise caused by mucus or saliva that is caught in the chest as a person is dying. By contrast, agonal breathing is an often brief period of abnormal breathing.
Decompensation progresses over a period of minutes even after the pulse is lost. Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
They might close their eyes frequently or they might be half-open. Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing.
Agonal breathing or agonal gasps are the last reflexes of the dying brain. They are generally viewed as a sign of death, and can happen after the heart has stopped beating.
The surge of energy before death is often referred to as “terminal lucidity.” This phenomenon occurs when a dying person, who may have been unresponsive or unconscious, suddenly becomes clear-minded, alert, and communicative.
The active stage of dying generally only lasts for about 3 days. The active stage is preceded by an approximately 3-week period of the pre-active dying stage. Though the active stage can be different for everyone, common symptoms include unresponsiveness and a significant drop in blood pressure.
Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest.
Terminal restlessness generally occurs in the last few days of life. Around 42 percent of hospice patients experience agitation during their final 48 hours. But even more develop symptoms before then, which may not subside until death.
The early post-mortem phase is most frequently estimated using the classical triad of post-mortem changes – rigor mortis, livor mortis, and algor mortis.
When someone dies there are several stages a body goes through as it decomposes over the first 24 to 48 hours. These stages assist medical examiners in determining how long a body has been dead. The three stages of decomposition are livor mortis, algor mortis, and rigor mortis.
A gurgling sound that comes from the back of the throat of a dying person. It is caused by the build-up of saliva and mucus in the throat and upper airways when the person is too weak to cough.