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Aluminium phosphide
*Zinc phosphide
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Fatalities, severe gastro-intestinal symptoms, fatigue, headache, dizziness, thirst, cough, soreness of breath etc., In severe cases coma, convulsions, hypotension and pulmonary oedema develop. Death due to shock and peripheral circulatory failure. |
Move patient to fresh air.
Lay patient on his side to prevent aspiration of vomits.
Remove patient to hospital.
Give CPR if indicated.
Preserve container to aid diagnosis.
Warning: Do not give water or water based drinks. |
Activated charcoal – slurry with sorbitol 30-100 g orally in adults, 15-30 g in children. – adsorbs phosphine
Diazepam – Give undiluted and monitor BP respiration. 5-10 mg IV, slowly over 2-3 minutes (Max. rate: 5 mg/min) Repeat every 10-15 minutes. Maximum dose: 30 mg.
Pediatric Dosage: 0.25-0.4 mg/kg IV, slowly over 2-3 min. Repeat every 2-5 min. Max. dose: 5 mg in children below 5 years and 10 mg in those above 5 years.
Phenytoin – Monitor BP, ECG. 10-15 mg/kg slow IV (Max. rate: 50 mg/min.) 100 mg orally or IV every 6-8 hours (Max. dose 1000 mg.)
Pediatric dosage: 15-20 mg/kg IV slowly (Rate: 1 mg/kg/min) 1.5 mg/kg every 30 min. Max. dose: 20 mg/kg/day.
Dopamine – 4.6 microgram/kg/min IV (to treat hypotension & shock)
Magnesium sulphate – 3 gm IV bolus followed by 6 gm in 12 hr. for 5-7 days. (Role controversial)
Ranitidine – 50 mg IV every 8 hours
Sodium bicarbonate - 50 mEq/15 min. If arterial bicarbonate is < 15 mmol/L.
Intravenous fluids- 4-6 L over 6 hour.
(Monitor by CVP)
Furosemide – Low dose ( may be tried for pulmonary oedema if systolic BP >90 mm HG).
Gastric lavage is contraindicated as more phosphine is released upon contact with water in the stomach. |
