Role of Potassium Permanganate (KMnO4) and/or vegetable oil gastric lavage in aluminium phosphide poisoning

Aluminium phosphide poisoning poses a common clinical dilemma in Asia. We, as Emergency physicians working in this part of the world frequently encounter patients with intentional intake of wheat/ rice tablets. Due to its highly toxic potential, the intake of a single tablet is enough to cause mortality. Its ability to liberate phosphine gas, leading to early systemic toxicity in terms of cardiovascular arrhythmias’, refractory hypotension and severe metabolic derangements are well observed. Despite multiple recent medical advances, there is no specific antidote thus the management remains mainly supportive. Our current practices, in managing aluminium phosphide toxicity are highly varied across the region. It is a common practice to use KMnO4 and/or vegetable oil gastric lavage in these patients which is considered to have a survival benefit. In this review article, we will search for the best evidence to answer this question whether there is a role of KMnO4 or vegetable oil gastric lavage in reducing the mortality.