Chapter 2: Complex medical situations

Breathing and secretions

In the final hours and days, changes often occur in the rate, depth and pattern of breathing.

  • Breathing may be more shallow or more rapid.

  • The patient may pause in their breathing, stopping for several seconds before starting again (called apnea).

  • Breaths can appear more indrawn or labored.

It is common that breathing becomes congested. This occurs when the patient is unconscious and no longer able to clear secretions from their throat, resulting in a rattling sound. The patient isn’t choking or gasping, and the congestion isn’t believed to cause them discomfort. However, the noise can be loud and unsettling or distressing for others to hear.