Hello and welcome to the St Emlyn's blog. I'm Simon Carley, and alongside me is Natalie May. This post addresses a frequent and potentially serious issue in emergency departments: the ingestion of button batteries. With Halloween and Christmas approaching, these small but hazardous objects become more prevalent in households with small children. Here, we provide critical insights for emergency physicians on identifying, managing, and preventing complications related to button battery ingestion.
Understanding Button Battery IngestionButton batteries, or disc batteries, are small, round batteries found in devices like watches, musical badges, and holiday decorations. Their size and shiny appearance make them attractive to children, who may ingest them or insert them into their noses or ears. While they appear harmless, button batteries can cause significant harm if they become lodged in mucosal surfaces.
The Risks of Button Battery IngestionWhen a button battery becomes wedged against a mucosal surface, it generates a small electrical current. This current can cause chemical burns and tissue damage within as little as two hours. If not promptly removed, the battery can lead to severe complications, including death.
Common Scenarios and SymptomsChildren often ingest various objects, but button batteries pose a unique risk due to their electrical properties. Here are common scenarios and symptoms to watch for:
Button batteries are radiopaque, making them visible on X-rays. They can be distinguished from coins by their characteristic double shoulder appearance. This feature is crucial for accurate diagnosis and timely intervention.
Management Strategies Immediate Steps for Suspected IngestionEven after successful removal, children must be monitored for complications. Discharge instructions should include warning signs such as gastrointestinal bleeding, severe abdominal pain, vomiting, respiratory distress, and refusal to eat. Follow-up appointments and possibly additional X-rays are essential to ensure no further damage has occurred.
Prevention Tips for ParentsEducating parents about the dangers of button batteries is crucial. Here are some tips to share with them:
A child was brought to the emergency department with a suspected nasal insertion of a button battery. Despite a thorough examination, no battery was visible. However, an X-ray revealed a large button battery lodged in the posterior nose. Prompt referral to ENT and removal prevented further complications.
Case 2: Esophageal LodgmentA child swallowed a button battery that became lodged in the esophagus. The battery was removed within two hours, but the child was monitored closely for weeks due to the risk of delayed complications. Despite initial removal, the child developed severe symptoms days later, highlighting the importance of vigilant post-removal care.
ConclusionButton batteries pose a significant risk to children, particularly during festive seasons when they are more prevalent in households. Emergency physicians must maintain a high index of suspicion, utilize radiological tools effectively, and act swiftly to manage cases of ingestion or insertion. Educating parents about the dangers and prevention strategies is equally important. Stay vigilant, stay informed, and ensure the safety of our youngest patients.
Additional ResourcesFor more information on button battery ingestion and other pediatric emergencies, visit the St Emlyn's blog. Follow us on Facebook and join our community of emergency medicine professionals dedicated to providing the best care for our patients.
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