Gastric decontamination in aluminum phosphide poisoning: Narrative review

Gastric decontamination in aluminum phosphide poisoning: Narrative review


  • Nima Safa Department of Emergency Medicine, Faculty of Medicine, Islamic Azad University, Islamic Azad University of Kerman, Kerman, Iran.
  • Fatemeh Rahmanian Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.


Aluminum Phosphide Poisoning, Gastric Lavage, Olive Oil, Coconut Oil


Background:  Despite significant progress in toxicology, there is no particular antidote for aluminum phosphide poisoning and the consequences of PH3 gas toxicity. While several researchers have concentrated on the technicalities of supportive intravenous treatment using various medicines such as sodium bicarbonate, Glucose-insulin-potassium protocol, and Digoxin or other methods; new research is attempting to enhance our interventions in the pre-absorption phase of phosphine gas.  Methods: A narration of literature.

Results: Some researchers are completely opposed to gastric decontamination using water-based solutions, the use of essential oils is proposed to avoid excessive PH3 release. In this study, we reviewed the literature for oil-based gastric decontamination methods. Based on our review, liquid paraffin might improve outcomes of ALP poisoning but it might be associated with adverse events. Evidence about coconut oil is still controversial which might be due to the co-administration of sodium bicarbonate in gastric lavage. Aloe vera, olive oil, and almond oil in gastric lavage have shown impressive benefits, but more evidence is needed.

Conclusion: To conclude, oil-based gastric lavage is associated with less mortality, and water-soluble washing methods and activated charcoal administration should be avoided.  



We would like to thank the Clinical Research Development Unit of Peymanieh Educational and ‎Research and Therapeutic Center of Jahrom University of Medical Sciences for providing facilities for ‎this work.‎

Authors Contributions:

NS: Contributed to the review by conducting a comprehensive literature search and identifying relevant studies for inclusion.

SA: Provided expertise in the topic area and helped conceptualize the review's framework and scope. Contributed to the critical evaluation of the studies included and helped draft the manuscript.

FR: Conducted a thorough review of the literature and extracted data from the studies included in the review. Also contributed to the analysis and interpretation of the results, and helped revise the manuscript.

RS: Provided insight into the clinical implications of the review's findings, as well as practical recommendations for healthcare providers. Contributed to the final editing and formatting of the manuscript.

Conflict of interest:

There are no conflicts of interest in this study.‎

Research funding: None.

Data availability: ‎ No data are available for this review study. ‎


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How to Cite

Safa, N., & Rahmanian, F. (2023). Gastric decontamination in aluminum phosphide poisoning: Narrative review. Updates in Emergency Medicine, 2(2). Retrieved from



Review Study