H Askkarpour , M* Amiri , M Naderi Lordjani , V Amiri , A Khodamoradi , M Khalilzadeh ,
Volume 11, Issue 3 (10-2020)
Abstract
Introduction: Aluminum phosphide is one of the most common causes of poisoning in the country. It liberates lethal phosphine gas when it comes in contact either with atmospheric moisture or with hydrochloric acid in the stomach. It mainly attacks the cardiovascular and respiratory systems. Eating even small amounts of this toxin can lead to death. This study reports a case of successful treatment of aluminum phosphide poisoning.
Case Report: A 23-year-old man was referred to the Lordegan Shohada hospital. He was admitted into the hospital approximately 35 minutes after taking half a pill with consecutive vomiting, nausea and exacerbation of gastrointestinal symptoms. The contents of the stomach were rinsed with charcoal and bicarbonate and half a liter of olive oil was given to him half an hour later. One liter of normal saline was infused due to low systolic pressure, 70 mmHg. Sodium bicarbonate (2-3 vials per hour) was started to correct metabolic acidosis and blood gases. In addition, 10 CC of calcium gluconate 10% every 8 hours, 1 g magnesium sulfate every 6 hours, and solution (insulin, glucose, and potassium: GIK) were given intravenously to the patient. On the third-day blood gases (PaCO2: 90, pH: 7.2, HCO3: 19) and blood pressure (10.60 mmHg) improved, and vital signs stabilized. Ejection fraction increased to 30% on day four and the patient was discharged after 6 days.
Conclusion: Effective measures in aluminum phosphate poisoning including prompt patient referral, careful and continuous care, rapid evacuation and dilution of gastric contents, administration of olive oil, and stabilization of cell membrane potential and ECMO can be useful.
