Spontaneous Ignition in Case of Celphos Poisoning

Abstract

Celphos (aluminum phosphide) poisoning is the most common cause of poisoning in India. The mechanism of action, acute and chronic effect on human body, its symptoms and signs, and the line of treatment are well documented and research is still going on to find a suitable antidote. "Spontaneous ignition" is a rare but interesting finding in case of aluminum phosphide poisoning. We present the autopsy findings in this case report along with the probable factors that led to occurrence of such finding.

A Systematic Review of Aluminium Phosphide Poisoning

“…When this limit is exceeded, phosphine can explode. Diphosphine, which is a product of the reaction between AlP and acid or moisture, burns spontaneously, reacting instantly with oxygen in the air, and this is one of the causes of explosions occurring during fumigation of storage grains (73). To prevent self-ignition AlP is mixed in the tablets with aluminium carbonate in the ratio 56:44, respectively (72).…”

Spontaneous Ignition Due to Intentional Acute Aluminum Phosphide Poisoning

“…Yadav et al reported a similar case of spontaneous ignition after the ingestion of AlP (15). The reason why this phenomenon does not always occur in people who ingest AlP is unknown.…”

“…Flammability limits, also called flammable limits or explosive limits, are the proportion of combustible gases in a mixture between which specified limits this mixture is flammable. When phosphine concentration exceeds its inflammable limits in air or in a closed and limited space, it is ignited and an explosion is highly likely (15). Furthermore, the reaction of AlP with acid or moisture liberates aluminum oxide and small amounts of diphosphine in addition to the PH 3 .…”

Proposal for a new mechanism of action for aluminum phosphide (ALP) for causing local injuries in ALP poisoning

“…2 Thermal injuries ranged from gastrointestinal ulcers and hemorrhages to external dermal burns resulting in death. 2 In addition to the effects of the independent variables (Table 1), [3][4][5] potassium permanganate used in treating ALP poisonings may have played a role in this phenomenon. 2,6 In most cases, this event occurs internally and is unobservable, providing a reason why combustion injuries are rarely reported despite multiple cases of ALP poisoning.…”

“…Attenuating by injecting an inert gas Hot atmosphere, high temperature 3,4 Hypothermia induction, transferring to cold area Negative pressure due to suctioning 3,5 Eliminating nasogastric suctioning from available interventions a Friction from nasogastric tube 5 Eliminating nasogastric lavage from available interventions a Exothermic reaction between potassium permanganate and organic matters 2,6 Elimination of potassium permanganate from treatment plan ALP: aluminum phosphide. a In both cases, instead of nasogastric lavage and suctioning, gastric ventilation is suggested to insufflate an inert gas into the stomach.…”