It is important for parents to be aware of the risks
that the button batteries found in the home setting from remote controls and
watches to musical greeting cards and toys pose to young children, say
researchers.
The incidence of button battery ingestion is
rising. Between 2007 and 2009, more than 3,400 cases annually were reported to
U.S. poison centers.
The clinical challenge for physicians who may evaluate
children who ingest button batteries is that they can be asymptomatic or
present with non-specific symptoms such as irritability, fever, cough, poor
oral intake and/or vomiting similar to those of a common viral infection. This,
combined with the likelihood of an unwitnessed ingestion event, is the recipe
for disaster, leading to a delay in the diagnosis and more severe injury.
"The clock is ticking when a button battery is
placed in the body," said Kris Jatana, MD, a pediatric head and neck surgeon at
Nationwide Children's Hospital. "In as little as two hours, these button
batteries can cause severe injury."
Button batteries, small and large, are dangerous
in the hands of a child. While the smaller batteries, such as those found in
hearing aids, will typically pass through the gastrointestinal system on their
own, the larger batteries can get stuck, causing the most significant injury
when swallowed by young children. Some complications from button battery
ingestions include eroding through the esophageal wall or into the adjacent
airway, damage to the nearby nerves which supply the vocal cords, or even more
serious - eroding into a major blood vessel such as the aorta which has always
been fatal.
"I have seen many otherwise healthy children
suffer serious injury from button batteries," said Dr. Jatana, also an
assistant professor of Otolaryngology-Head and Neck Surgery at The Ohio State
University College of Medicine. "While educating parents about the dangers of
these batteries is important, it is equally important for physicians to be
aware of the increasing frequency of button battery ingestions when evaluating
children in the primary care or emergency room setting. An x-ray can be done to
confirm the diagnosis." If a child is suspected of swallowing or pushing a
button battery into their nasal cavity or ear canal, the child needs to be
taken to an emergency room immediately. The diagnosis can be confirmed by a two
view x-ray, which from a distance, may be mistaken for a commonly ingested
foreign body in children - a coin. The key to differentiating a button battery
from a coin is to magnify or zoom into the image to look for the double ring or
halo seen around the button battery. In addition, on the side view x-ray, one
can often see a small step-off or notch with most batteries. "Identifying a
metallic foreign body as a button battery is critical as the battery creates an
electrical current around the outside of the battery generating hydroxide, an
alkaline chemical, causing the rapid tissue injury," said Dr. Jatana.
The treatment for a button battery lodged within
the body is emergent removal. When swallowed, these batteries can get lodged in
the esophagus which requires general anesthesia for removal in an operating
room. When pushed into the ear canal or nasal cavity, the removal can usually
take place in an emergency room setting.
On March 17, 2011, Dr. Jatana presented with a
panel of experts from across the country to the U.S. Consumer Product Safety
Commission (CPSC) in Bethesda, on the hazards of button batteries. Later on
that month, the CPSC released a public warning statement emphasizing the
dangers of button batteries to consumers. In June, two U.S. senators, Senator
John D. Rockefeller and Senator Mark Pryor, introduced new legislation entitled
the "Button Cell Battery Safety Act of 2011." If this legislation passes
through Congress, the CPSC would be able to regulate electronic devices that
contain these batteries to make them safer for children. "The initiation of
this legislative process shows the true commitment of members of U.S. Congress
and the CPSC to the safety of children," said Dr. Jatana.
"Parents need to be aware of this potential
household risk to ensure that button batteries themselves, and any electronic
devices that do not contain them in a properly secured compartment, are kept
out of the reach of young children," said Dr. Jatana.
Source-Newswise