Battery Ingestion Can Cause Serious Injury

Today’s Batteries Are Smaller and More Powerful 

          With the Christmas season revving up and soon to be in high gear, this seems like a good time to review the potential danger of battery ingestion.  When it comes to Christmas presents, little has changed over the years.  Toys are still the name of the game for ‘kids from one to ninety-two’.  What has changed is the plethora of electronic games and devices now on everyone’s Christmas list and the number and variety of batteries required to operate these and other popular toys.  As many of these devices have become smaller, batteries have had to accommodate them by becoming more compact and more powerful.  At any time of the year it is important to be aware of the potential danger posed by batteries and to take steps to keep them out of reach of younger children. 

Types of Injury 

          One of the most common battery types is the disk or button battery used in many electronic devices.  The small size of these batteries belies the serious injury they can cause when ingested.  These batteries contain heavy metals such as lithium as well as caustic electrolytes.  When one of these batteries is ingested, usually accidentally by children under the age of 4 years or by elderly individuals, it can lodge in the esophagus, the tube connecting the mouth and the stomach.  If this happens, injury can be caused in several ways: (1) by the electrical current that occurs, (2) from the pressure exerted against the wall of the esophagus, or (3) by the leakage of caustic alkali.  These injuries can lead to burns and even perforation of the esophagus.  Occasionally a small battery will become lodged in the airway and cause difficulty breathing.  This, again, is a true medical emergency and requires immediate evaluation and treatment.  It is important to note that button type batteries placed in the nose or ears can also cause injury. 

Symptoms 

          Because serious injury can occur in as little as two hours, it is important to recognize the problem early and seek medical attention.  There may be no obvious symptoms of battery ingestion, but patients may have vomiting, cough, difficulty swallowing, decreased appetite, abdominal pain, low grade fever, irritability or drooling.  You should not wait until symptoms develop before seeking medical care.  While the great majority of ingested batteries pass through the esophagus and the rest of the GI tract until they are eliminated in the stool, about 10 percent of ingestions can lead to serious injury and sometimes even death. 

Treatment 

          Battery ingestion is a medical emergency, so if it is suspected you should go immediately to the nearest emergency room.  The patient should have nothing by mouth until they can be evaluated by a medical professional.  If it is possible to identify the suspected battery without delaying definitive evaluation and treatment, this information may be helpful for emergency room personnel.  Your health care provider will take an x-ray to confirm that a battery has been ingested, particularly if the patient is a child twelve years of age or younger.  An x-ray will also help distinguish between a coin, a button or a battery.  If an x-ray confirms that a battery has been ingested, but has passed beyond the esophagus, it should be monitored until it has been eliminated.  Most batteries will pass in the stool within 72 hours, but can take as little as 12 hours or as long as 14 days.  If the battery is lodged in the esophagus, it must be removed immediately, usually under direct visualization by endoscopy.         

Prevention 

          Batteries should be stored in childproof containers and the battery compartments on toys and other electronic devices should be securely fastened.  Elderly individuals should not keep batteries near pills and the mouth or teeth should not be used to hold batteries while they are being replaced.  If there is any question whether someone has ingested a battery it is best to seek immediate treatment at the nearest emergency room.  Both patients and health care providers can consult the National Battery Ingestion Hotline at the National Capital Poison Center by calling 202-625-3333 any time of the night or day.  Here’s hoping you have a safe and happy holiday season.