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How do you count heartbeats and how do you know when a patient is about to pass away?

Hi! I'm Ms. Lambert at the International Community School. My 4th graders have a few questions and I'd like to share your advice with them. Thanks in advance!

#medicine

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Dan’s Answer

To count heart rate (HR), you use your pointer and middle finger to feel the heart beat on your distal radial artery (under your thumb at your wrist with your palms up). You measure 15 secs on your watch and count the beats you feel within that time frame, once done, multiple that by 4 and you have the HR. It is counted in "beats per minute".

There are a few signs that occur when one is ready to pass, I think the most talked about is the so called "death rattle" which is essentially the body losing it's ability to normally swallow saliva, it causes a gurgling like noise which may seem distressful but isn't for the patient. Another famous sign is what we call Chyene-stokes respiration, where the patient gets a sudden burst of breathing following by no breathing, it cycles after that. Other signs are more subtle such as a decrease in urination and bowel movement as well as a decrease in oral intake of food or fluid. Everything sorts to slowly decrease such as energy, interaction, heart rate, blood pressure, breathing until it all stops.

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Janice’s Answer

Hello Mrs. Lambert and class,

As a nurse, I see people pass away daily in the hospital setting. Many people, however, recover and are discharged home.

People can pass away after a long battle with a chronic condition such as heart disease or lung disease. Typically shallow breathing, loss of awareness, and a low blood pressure are indicators of impending death.

Most people can still hear, so it is wise to talk with the patient until they pass. Additionally, I would want to stay with the member to comfort them in their final days, minutes or hours.



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