Counsel parents in your practice that young children can be seriously injured or die from playing with or ingesting button batteries.
Injuries from these coin-sized batteries are on the rise, with 2.5 times as many children under age 13 showing up at an emergency department in 2010 compared with 1998, according to a study in the Aug. 31 issue of Morbidity and Mortality Weekly Report (2012:61:661-6). This increase from 1,900 cases in 1998 to 4,800 in 2010 aligns with the growing popularity of these batteries in remote controls, toys, light-up jewelry, and other devices.
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Injuries from children playing with or ingesting button batteries are on the rise.
"As the use of these batteries expands, so do the estimated number of ED-treated battery exposures in children, with the vast majority of these involving ingestions," Jacqueline Ferrante, Ph.D., of the U.S. Consumer Product Safety Commission (CPSC) Division of Health Sciences, and her colleagues stated in the report.
Injuries from batteries placed in a child’s nose or acid burns from ruptured batteries also are included in the report.
"Ensure that parents are aware of the problem so that batteries are kept away from young children," Dr. Ferrante said in an interview. Advise them to check remote controls and other electronic devices for easily accessible battery compartments, especially those that can be opened without a screwdriver, she advised.
An estimated 40,400 children younger than 13 years were treated at U.S. emergency departments for battery-related injuries between 1997 and 2010.
Additional CPSC databases covering 1995-2010 were searched for battery-related deaths in children under age 13. Of the 14 reported deaths, 12 children had confirmed exposure to button cell batteries. All children who died were aged 4 years and younger.
Diagnosis can be a challenge. Not all children can or are willing to report swallowing a battery or giving one to a sibling, the authors noted. In addition, the typical vomiting, abdominal pain, fever, diarrhea, respiratory distress, and dysphagia associated with battery ingestion are nonspecific symptoms (Pediatr. Emerg. Care 2008;24:313-6).
"Consider battery ingestion in the differential diagnosis of any child presenting with nonspecific GI symptoms or unexplained respiratory distress because of the serious consequences associated with a delayed or missed diagnosis," Dr. Ferrante said.
Complicating matters is the timing of injury, which can vary from 2 hours after ingestion for serious esophageal burns to more than 2 weeks for fatal hemorrhage following endoscopic removal of a button battery. The growing recognition of these injuries drove pediatric gastroenterologists at the University of Colorado Denver to develop guidelines for the management of button battery–induced hemorrhage (J. Pediatr. Gastroenterol. Nutr. 2011;52:585-9).
Nickle-sized, 3-V lithium button batteries can easily lodge in a child’s esophagus, and were most frequently associated with serious complications and death, according to the report.
Although outside the scope of the report, Dr. Ferrante also suggested pediatricians warn parents about ingestion of strong powerful magnets. This is another often-overlooked injury with similar issues and consequences, she said. "There are even cases where injury resulted from co-ingestion of a button battery and a strong magnet."
For the current study, Dr. Ferrante and her colleagues analyzed the National Electronic Injury Surveillance System (NEISS) database to quantify nonfatal, battery-related ED visits. They assessed other CPSC data to identify the battery-related deaths.
The NEISS data only comprise emergency department visits, so any child treated for battery ingestion in a doctor’s office or as an outpatient is not included in the study, a potential limitation. In addition, the number of fatal incidents involving batteries and children younger than 13 years is likely underrepresented because of the type of data collected, the authors noted.
The authors had no relevant financial disclosures. Click here for more information on battery hazards provided by the U.S. Consumer Product Safety Commission.