There is nothing that will raise the ire of a pediatric nurse more than a preventable pediatric death. So, in an effort to educate the public, today I’m focusing on a very real danger in your home that could kill your child if ingested and that is the button battery.
Button batteries are those disc shaped, silver batteries that are found in hearing aids, watches, weight scales, and often toys. I would be surprised if you didn’t have these in your home.
Typically they are swallowed by younger children (age 1-3) who may or may not tell you what has happened. We can tell the difference between a button battery and a coin by a characteristic halo appearance of a button battery on x-ray. If you look at the underside of the battery, you’ll see this gap that will show on film.
If the battery becomes lodged in the upper esophagus, it leaks a highly caustic alkaline solution, even if the battery is spent, that begins to erode through tissue. This process happens quickly. I’ve seen these burns develop in just two hours. These burns can lead to scarring and long term complications— that can be a minor complication.
There is also a deadly complication. Even after the battery is removed, this alkaline solution can remain in place, eroding and burning away tissue. Typically, the cause of death in a button battery ingestion is hemorrhage because this solution eventually erodes through a major blood vessel. Even if the patient is in a hospital when the bleeding starts it is very difficult to repair.
1. Button batteries need to be treated as highly toxic objects. They should be kept out of the reach of children (even locked up) like other dangerous objects in your home.
2. Toys that have button batteries need to have screws that lock them in place. Toys should be checked frequently to be sure this compartment stays locked. Best case is not to have these types of toys in your house at all with younger kids.
3. Be aware of items in other environments that have button batteries. Button batteries are used in hearing aids. So be careful at grandma and grandpa’s house and have a discussion with any caregiver about the dangers of having these unsecured.
4. Give age appropriate education to other children in the home about how dangerous button batteries are. Tell older children to tell you immediately if they see a younger sibling with anything in their mouth that they’re not supposed to have. Have them show you toys when they break to see if the battery has become loose. If it’s not there— find it.
5. If swallowed, proceed immediately to the closest emergency department. I mean, really drive there now. You don’t need to call 911 but you do need to go. Do not delay being seen. Button battery ingestions are a true emergency. Your child should immediately receive and x-ray to determine the location of the battery. Treatment depends on its location.
6. If discharged home after a button battery ingestion, any bleeding needs to be treated as an emergency as well. If bleeding is significant then you should call 911 and be transported. Even minor (or spot) bleeding from the mouth needs to be evaluated emergently.
As one of my physician co-workers said, “Respect the button battery.”
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