True Story…..A 22-month-old boy fell to the bathroom floor, began vomiting blood, and stopped breathing. His family called paramedics. The child died in the emergency room before his x-ray could be interpreted. An autopsy revealed that he had swallowed a button battery that had lodged in and severely burned his esophagus. He died from internal bleeding. The circumstances and timeframe surrounding when the child found and swallowed the battery remain unknown. The family reported that he was acting like himself up until the day he died, except for acting as if he needed more attention than usual.
As the popularity of button or disk batteries increases, severe injuries, to the point of death, are also increasing for young children and toddlers. Button or disk batteries are found in many household items, such as children’s books, toys, TV remote controls, watches, calculators, hearing aids, flashlights and key fobs. Many of these products contain newer and stronger batteries. Compared to the 1.5-volt button batteries of the past, the larger 3-volt lithium batteries have increased the risk of life-threatening injuries dramatically.
The coin-sized lithium battery possesses a strong electrical charge when out of the electronic unit. If swallowed by a child, it can become lodged in the upper esophagus and react quickly with saliva. The battery discharges a current that hydrolyzes water and generates hydroxide, creating a caustic (alkaline) injury to the tissue. Serious damage occurs in just two hours.
A caregiver may not know that a child has swallowed a button battery. The erosive injury from the battery progresses rapidly over several hours. The child may vomit, refuse food, develop a fever or cough and become listless. These symptoms mimic many common childhood illnesses and obscure the correct diagnosis.
EVERY MINUTE COUNTS! Prompt medical attention is essential when caregivers find an opened battery compartment or missing battery that may have been swallowed by an infant or young child. Children with suspected battery ingestions must be taken to the nearest Hospital Emergency Room for IMMEDIATE evaluation. A proper diagnosis cannot be made by a history or physical exam alone. X-rays are essential and should include the child’s entire body. Batteries may be mistaken for coins on X-ray. However, batteries will have a distinctive “halo rim” around the edges of the image on a high-quality X-ray that a coin will NOT have..
Safe removal can be difficult and even hazardous. Physicians with specialized skills are often needed. Critically ill children may need to be hospitalized in a pediatric intensive care unit after removal to ensure that an injured esophagus heals without perforation or scarring.
PREVENTION is the BEST MEDICINE!
- Ensure that children do not have access to button batteries!
Check products that use button batteries. - Ensure that the battery compartment is securely closed and that it requires a tool, such as a screwdriver, to open it.
- Batteries should be stored out of children’s reach and disposed of safely.
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