Monday, October 09, 2006
5:41:00 PM
Are you ready to die?
Are you ready to die? JackassX: Total Abstraction from an article
Changes During the Dying Process
Change
Manifest by/Signs
Fatigue, weakness
Decreasing function, hygiene
Inability to move around bed
Inability to lift head off pillow
Cutaneous ischemia
Erythema over bony prominences
Skin breakdown, wounds
Decreasing appetite/food intake, wasting
Anorexia
Poor intake
Aspiration, asphyxiation
Weight loss, loss of muscle and fat, notable in temples
Decreasing fluid intake, dehydration
Poor intake
Aspiration
Peripheral edema due to hypoalbuminemia
Dehydration, dry mucous membranes/conjunctiva
Cardiac dysfunction, renal failure
Tachycardia
Hypertension followed by hypotension
Peripheral cooling
Peripheral and central cyanosis (bluing of extremities)
Mottling of the skin (livedo reticularis)
Venous pooling along dependent skin surfaces
Dark urine
Oliguria, anuria
Neurologic dysfunction, including:
Decreasing level of consciousness
Increasing drowsiness
Difficulty awakening
Unresponsive to verbal or tactile stimuli
Decreasing ability to communicate
Difficulty finding words
Monosyllabic words, short sentences
Delayed or inappropriate responses
Verbally unresponsive
Terminal delirium
Early signs of cognitive failure (eg, day-night reversal)
Agitation, restlessness
Purposeless, repetitious movements
Moaning, groaning
Respiratory dysfunction
Change in ventilatory rate -- increasing first, then slowing
Decreasing tidal volume
Abnormal breathing patterns -- apnea, Cheyne-Stokes respirations, agonal breaths
Loss of ability to swallow
Dysphagia
Coughing, choking
Loss of gag reflex
Buildup of oral and tracheal secretions
Gurgling
Loss of sphincter control
Incontinence of urine or bowels
Maceration of skin
Perineal candidiasis
Pain
Facial grimacing
Tension in forehead, between eyebrows
Loss of ability to close eyes
Eyelids not closed
Whites of eyes showing (with or without pupils visible)
Rare, unexpected events:
Bursts of energy just before death occurs, the "golden glow"
Aspiration, asphyxiation
http://www.medscape.com/viewarticle/542262_3
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