Death rattles

Hyoscine 0.4-0.8 mg, 4-8 hourly, can be used to dry secretions and stop the 'death rattle'. Dyspnoea

Identify the cause, such as a pleural effusion, and treat as appropriate. Pleural taps can be performed readily in the home. Corticosteroids can be given for lung metastases. Oxygen may be necessary to help respiratory distress in the terminal stages and bedside oxygen can be readily obtained. Morphine can be used for intractable dyspnoea, together with haloperidol or a phenothiazine for nausea.

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