n When their blood pressure starts going down, their heart rate goes up.  Their blood pressure may go down.  Their respirations may increase and then the patient experiences what’s called a mammalian’s diver’s reflex where by the blood is shunted to the central part of the body from the periphery of the body. So that usually two to three days prior to death, sometimes four days, the hands and the feet become extremely cold.  They become mottled.  That is you look at the hands and they have a bluish appearance.
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