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Dyspnea, Death Rattle, and Cough 

Dyspnea, Death Rattle, and Cough
Chapter:
Dyspnea, Death Rattle, and Cough
Author(s):

Deborah Dudgeon

DOI:
10.1093/med/9780190244286.003.0002
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date: 18 October 2019

Dyspnea is a common symptom in people with advanced disease and, like pain, is a subjective experience that may not be evident to an observer. The prevalence of dyspnea varies according to the stage and type of underlying disease and the methodologic design of the studies. Noisy, rattling breathing in patients who are dying is commonly known as death rattle or terminal secretions. This noisy, moist breathing can be very distressing for the family, other patients, visitors, and healthcare workers because it may appear that the person is drowning in his or her own secretions. Cough can be very debilitating to people with advanced disease, leading to sleepless nights, fatigue, pain, and, at times, pathologic fractures. Hemoptysis can also be a consequence. The optimal treatment of each of these symptoms is to conduct a comprehensive assessment, treat reversible causes when possible, and use pharmacologic and nonpharmacologic therapies.

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