Figure 1: Management protocol for acute aluminum phosphide toxicity at our center (PGIMER, Chandigarh, India). ^aGIK protocol: Insulin regular loading dose of 0.5–1 IU/kg, followed by 0.5 IU/kg/h infusion (can be increased up to 10 IU/kg/h). Dextrose 0.5–1 g/kg loading dose, followed by 0.5–1 g/kg/h infusion; maintaining plasma glucose level between 140 and 180 mg/dL. IV K supplementation to maintain normal serum levels; monitoring levels every 8 h along with continuous ECG, ^bMgSO4 protocol: Loading dose 3 g over 3 h infusion, followed by 1.0-1.5 g every 6 h. ARDS: Acute respiratory distress syndrome, BP: Blood pressure, CBC: Complete blood count, CRRT: Continuous renal replacement therapy, CXR: Chest X-ray, ECG: Electrocardiography, ECMO: Extracorporeal membrane oxygenation, GIK: Glucose-insulin-potassium, IABP: Intra-aortic balloon counterpulsation, INR: International normalized ratio, IV: Intravenous, LFT: Liver function test, NS: Normal saline, PT: Prothrombin time, RFT: Renal function test, RRT: Renal replacement therapy