Aluminium phosphide poisoning: a growing concern in pediatric population.

Twenty cases of ALP poisoning aged between 7-12 years who were admitted in the Pediatric Emergency Services between July 1995 to July 1996 were evaluated. The diagnosis was made on the basis of the history of ingestion and positive silver nitrate tests on gastric lavage fluid. All routine investigations including, serum electrolytes, liver function tests, renal function tests, acid blood gas analysis and close electrocardio-graphic monitoring, were done in these cases. Gastric lavage, activated charcoal, antacids, intravenous ranitidine and management of shock (intravenous fluid + dopamine + hydrocortisone) and relevant therapy for cardiac arrhythmias, anemia, seizures and metabolic acidosis were the mainstay of treatment. We observed hypo-magnesemia in all the 20 cases and magnesium sulphate in a dose of 200 mg/kg intravenously (6 hourly or 4 hourly, depending upon the severity) was used. Out of 20 cases, 12 (60%) had presented with shock, 4 (20%) with hematemesis and malena, 2(10%) with hematemesis and shock and 2 (10%) with acute respiratory distress (ARD). The overall mortality was 55%; the