Before passing away, the manifestations before death will include cold, wet, pale skin, blue-purple lips, lowered blood pressure, low and feeble heart sounds, fast and weak pulse, and very irregular or even not palpable. The respiration is shallow and difficult, and there are tidal and dying respiration, that is, double inhalation, sighing, nodding-like respiration and so on. Pupils are dilated, various reflexes are gradually lost, and muscle tone is reduced or lost. Usually the breathing stops first, followed by cardiac arrest, the apical beat often disappears last, there are other sensations, changes in consciousness, hearing is often the last sensation to disappear in the patient.