For aluminium phosphide ingestion, paraffin (mineral) oil-based gastric decontamination has the best recent clinical evidence, not water-based lavage. A 2024 systematic review/meta-analysis of 7 RCTs found paraffin oil associated with lower mortality and less need for intubation and vasopressors. Review abstract

Important: this is a high-fatality emergency with no proven antidote. Gastric lavage should only be performed in a hospital by an experienced toxicology/emergency team, after airway assessment/protection. Do not induce vomiting or attempt home lavage. Contact emergency services / a poison center immediately.

Older protocols also mention dilute potassium permanganate with coconut or mineral oil, but potassium permanganate support is less secure and practices vary. Current evidence favors paraffin oil as the oil-based agent. Supportive critical care for shock, arrhythmias, acidosis, and respiratory failure is central.