A 64-year-old man with advanced heart failure is considered to be in the last days of life. He develops noisy respiratory secretions ("death rattle") ...

Question

A 64-year-old man with advanced heart failure is considered to be in the last days of life. He develops noisy respiratory secretions ("death rattle") which are distressing to his family, although he appears comfortable. What is the most appropriate management?

Accepted Answer

Reposition him and consider a subcutaneous antimuscarinic such as Glycopyrronium

Answer

Perform deep suctioning of the oropharynx regularly

Answer

Start high-flow oxygen to reduce the noise

Answer

Increase intravenous fluids to thin secretions

Answer

Intubate and ventilate to protect the airway

uk-plab-1 MCQ (SBA): End-of-life noisy secretions

A 64-year-old man with advanced heart failure is considered to be in the last days of life. He develops noisy respiratory secretions ("death rattle") which are distressing to his family, although he appears comfortable. What is the most appropriate management?