Respiratory Secretions

Respiratory Secretions


Noisy breathing is an indicator of impending death, occurring in about half of people who are actively dying. It can sometimes be referred to as respiratory secretions, gurgly breathing and the death rattles. This symptom can be exacerbated by the administration of parenteral fluids.

Noisy Secretions are common in the terminal phase of a palliative illness. It is controversial as to whether the medicines are beneficial.

Prescribing Guidance

The CareSearchgp App provides prescribing information on this issue

The palliMEDS app provides GPs with advice on managing this symptom with palliative care medicines endorsed by the Australian & New Zealand Society of Palliative Medicine (ANZSPM). The app is a collaboration between NPS MedicineWise and caring@home.

Tasmanian Adult Palliative Care Formulary

Eastern Metropolitan Region Palliative Care Consortium (Victoria)

Useful information


CarerHelp has a fact sheet on

Therapeutic Guidelines: Palliative Care (subscription required)


  • It is often helpful to counsel the family and carers that the person is unlikely to be aware of, or distressed by the symptom.
  • Respiratory tract secretions are a normal part of dying; medicines provide little or no response for a large number of people.
  • Repositioning the person from side to side can sometimes help them clear the secretions.
  • Suction is unlikely to be helpful in most cases and can be distressing for the person.

Page last updated 12 March 2024