Opi
Calc
BODE Index (Palliative context)
CAM-S (Confusion Assessment Method - Severity)
CPOT (Critical-Care Pain Observation Tool)
Death Rattle Scoring (Victoria)
Distress Thermometer
Edmonton Symptom Assessment System (ESAS-r)
FAST Scale (Dementia)
IPOS (Integrated Palliative Outcome Scale)
Memorial Symptom Assessment Scale (MSAS)
Menten Score
Morphine Equivalent Daily Dose (MEDD)
Nursing Delirium Screening Scale (Nu-DESC)
Opioid Risk Tool (ORT)
PAINAD Scale
Palliative Performance Scale (PPSv2)
Palliative Prognostic (PaP) Score
Palliative Prognostic Index (PPI)
Respiratory Distress Observation Scale (RDOS)
Richmond Agitation-Sedation Scale (RASS-PAL)
Seattle Heart Failure Model (SHFM)
e-PaP Score
Death Rattle Scoring (Victoria)
Death Rattle (Victoria Scale): 0-3 severity of terminal secretions. Guides family counseling and anticholinergic therapy.
Death Rattle Severity
0 - Absent: No audible death rattle
1 - Mild: Occasional quiet rattling sounds
2 - Moderate: Frequent or louder rattling sounds
3 - Severe: Persistent, loud rattling audible from distance
Assess Death Rattle
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Assessment of terminal secretions ("death rattle") in dying patients
Guiding family education about end-of-life physical changes
Determining need for anticholinergic medications
Monitoring response to comfort interventions
Clinical Context
Provides language to normalize terminal secretions and guide supportive family conversations.
Section 2
Formula & Logic
Severity Grading
0 = None
No audible secretions
1 = Mild
Occasional rattling; audible only when listening closely
2 = Moderate
Persistent rattling; audible at bedside during conversation
3 = Severe
Loud rattling; distressing to family and patient
Section 3
Pearls/Pitfalls
Key Advantages
Simple 0–3 severity scale
Helps normalize common end-of-life phenomenon
Guides anticholinergic therapy decisions
Facilitates family conversations
Last Comprehensive Review: 2026
Related Palliative Care Tools
Menten Score
Edmonton Symptom Assessment System
IPOS
Distress Thermometer
Memorial Symptom Assessment Scale
Morphine Equivalent Daily Dose
Opioid Risk Tool
PAINAD Scale
CPOT
Respiratory Distress Observation Scale
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