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Beware of button batteries

Thursday, December 22, 2016

As the big day approaches, NHSGGC has issued a stark warning to parents over the risks to children of button batteries. 

If swallowed, button batteries can have devastating consequences for children, causing  severe burns to the internal tissues.  Often the damage to the child’s oesophagus, or gullet, can be extensive and they can require years of treatment. In extreme cases, they can be lethal.

Button batteries are often contained in toys and cards – and therefore many more may be found around the home at Christmas.

Tash Kunanandam, Consultant Paediatric Otorhinolaryngologist, Royal Hospital for Children Glasgow said: “These batteries cause maximal damage when they are swallowed and get stuck in the oesophagus.  Similar to any hard ingested foreign body, they can cause some damage by a pressure effect. 

“However, most of the devastating effects in these cases are actually due to chemical injuries.  The chemical effects can occur, firstly, due to the generation of an electrical current resulting in hydroxide production from hydrolysis of tissue fluids and secondly, by leakage of alkaline contents.  These deep burns can be severe enough to cause problems to nearby structures such as the airway. 

“Any child who swallows a foreign body that gets stuck in the oesophagus, more often than not, has a normal recovery after the object has been removed, with no further trips to hospital needed.  

“In the case of button batteries however, especially those that have been stuck for a period of time, the length of treatment can be long-term and potentially life-long.  Parents and children often find themselves having to attend several hospital visits to address, principally, swallowing issues.  This can involve multiple operations and periods of tube feeding.”

Lesley Nish, HI Senior for NHSGGC  said: “Button batteries can be found in many items around the home such as toys, jewellery and watches, kitchen or bathroom scales, general musical celebration cards, remote controls, musical books, calculators and key fobs – and are also  found in increasing numbers over the festive period.  Some families may also keep supplies of button sized batteries at home in order to replace them when they need to.

Lesley added: “The size of button batteries means that a child can easily put one into their mouth, nose or ear.  A button battery is small and shiny, so may be more appealing for toddlers and young children, however, older children can also swallow them.

“Parents and carers need to be vigilant about this all year long, but particularly at Christmas when there are lots of new gifts, musical cards and decorations around the house.

“Toys with button batteries should include a secure battery compartment, usually containing a screw to secure it and one that children should not be able to open.  Children can easily and swiftly explore small containers or difficult to open containers and can learn to open child resistant closures more easily than some adults.  Opening up a battery compartment can also be easy for a child if it’s not secure.

“Fortunately across NHSGGC, the numbers of children affected seems to be low, however one child in England died recently after swallowing one.   This means we cannot be complacent and need to highlight the potential risks to children living in our area. We are asking all staff and parents to be mindful of the dangers these button batteries pose to their children.”

The advice from NHSGGC is:

  • Take the child to an Emergency Department immediately if a child swallows or puts a button sized battery in their nose or ear. 
  • Keep products containing small button sized batteries out of reach and sight of children.
  • Check toys that require small button sized batteries and check that they have a secure battery compartment that cannot be opened by children. If a toy has a compartment for button sized batteries that is not secure, children should not play with it.
  • The most important aspect of managing this problem is in its early recognition.  Fortunately button batteries are visible on chest radiographs and this should be performed if there is any suspicion at all.  If present, they should be removed as soon as possible to avoid significant long term injuries.  This requires urgent referral to the on call ENT team for button batteries lodged in the oesophagus or indeed the ear or nose.  Treatment can involve multiple surgical specialities including general surgery and cardiothoracic surgery, particularly in complex cases.

Elizabeth Lumsden, community safety manager, RoSPA Scotland said: “As more and more electronic items are introduced into the family home, the potential for children to swallow button batteries increases, and this can lead to choking or poisoning. We want parents, grandparents, childminders and carers to be aware of the danger and understand that these seemingly harmless little batteries can cause serious injury to children.”

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