Death Rattle and Oral Secretions

The Palliative Care Network of Wisconsin (PCNOW) provides peer-reviewed, evidence-based summaries of key palliative care topics (“Fast Facts”). As consciousness decreases in the dying process, patients lose their ability to swallow and clear oral secretions. Air moves over these pooled secretions resulting in noisy ventilation. While there is no evidence that patients find this ‘death/inspiratory rattle/gurgle’ disturbing, evidence from bereaved surveys suggests the noises can be disturbing to visitors and caregivers who may fear the patient is choking. This Fast Fact reviews the background, causes, non-pharmacological treatments, and pharmacological treatments associated with death rattle and oral secretions.

Links: Fast Facts #109 (Updated 8/2022)