Cookie monster of a pediatric ingestion of zinc phosphide

• Published in: The American journal of emergency medicine Vol. 58; pp. 349 - 349.e7
• Main Authors: Allen, Robert, Furlano, Emma R., Su, Mark, Wiener, Sage W.
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Limited 01-08-2022
• Subjects: Air purification; Disaster medicine; Emergency medical care; Funding; Hazardous materials; Hydrochloric acid; Ingestion; Patients; Pediatrics; Personal protective equipment; Phosphine; Protective equipment; Respirators; Rodenticides; Toxicity; Writing; Zinc; Zinc phosphide
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2022.04.043

BackgroundZinc phosphide is a highly toxic rodenticide that reacts with hydrochloric acid in the stomach to form phosphine gas. Ingestion of zinc phosphide can result in consequential toxicity even when ingested in small quantities. Clear guidelines are lacking on appropriate personal protective equipment for providers to avoid additional exposure.Case presentationWe present the case of a four-year-old boy who suffered mild gastrointestinal symptoms after an unintentional ingestion of zinc phosphide. After discussion with the regional Poison Control Center, providers wore powered air-purifying respirators in a negative pressure room and experienced no symptoms of phosphine exposure. The patient was discharged the next day after a complete recovery.ConclusionsClinicians should be aware of the potential clinical ramifications to patients who ingest zinc phosphide and the potential risks of caring for such patients. To prevent additional exposure, providers should don appropriate personal protective equipment and contact HAZMAT (or local health department) to safely remove additional zinc phosphide.