Button batteries can kill if swallowed

If a child has swallowed a battery take them immediately to A&E / the Emergency Room.

Click picture for safety-advice

Button batteries can kill if swallowed.

The potential harm from small “button” batteries has recently made the news. There have been some awful cases involving children who’ve swallowed one and who’ve died or been seriously harmed.

These batteries can be found in a variety of situations – toys are an obvious category, or musical greeting cards that play a melody when opened. They’re also in everyday medical devices like hearing aids and blood glucose meters.

You can see how much damage can be done from this time-lapse video which shows batteries placed between two layers of ham (to mimic an oesophagus, for example).

Recent news articles

(1) Doctor’s warning over ‘killer’ button batteries (29 December 2015) Leicester Mercury
– this aricle highlights the frequency of these batteries being swallowed (or put in noses) as seen by one hospital, including the recent death of a very young child.

Dr Rachel Rowlands, quoted in the article, is campaigning for better awareness of battery harms and noted that even if the child survives it may suffer long-term consequences:

“If the battery gets stuck in the windpipe or stomach it can make a electrical circuit and the battery produces caustic soda.

“This can not only kill but it can leave children with burns and they need to keep having operations.”

See Rachel’s talk (video) for NHS England at the end of this post.

(2) Toddler’s death puts spotlight on battery dangers (31 December 2015) The Oklahoman
– this article reports on the death of a child who happened this Christmas after swallowing a battery (note that the child’s autopsy is pending so an official cause of death is not known).

“Normally the battery passes through the digestive system” [Randy Badillo, Oklahoma Poison Control Center senior specialist] said.

But, if the battery lodges in the esophagus or digestive tract, it can open and release an alkaline substance that can cause corrosive or burning injuries.”

(3) Boy swallows small battery and is saved by grandmother (date not given) Reshareworthy

“It happened to 4-year-old Hunter, a young boy with natural curiosity, after he swallowed a button battery. Luckily, his grandmother rushed him to hospital. Doctors had to work fast to remove it from his windpipe before it caused damage.”

Chitra Acharya, from Swansea University, co-wrote an article for the British Academy of Audiology after she found problems in the way a case was handled where a young child appeared to have swallowed the battery from a hearing aid (the child’s own). Although this case was a near-miss requests for a replacement hearing aid with a tamper-proof battery compartment were not consistently followed-up and there seemed to be no coherent response to battery risks in audiology departments, despite an awareness of the problem.

What can be done?

Keep batteries out of children’s reach – even ‘dead’ ones
Used batteries can still cause great harm if swallowed. If you have multipacks of button batteries these are usually in segmented blister packs and children may be able to open them.

Raise awareness – it is a potential medical emergency
Parents and carers need to be aware – even if a child seems fine if there is a battery missing from something they were playing with and it is worth getting them checked.

Hopefully doctors and nurses understand the seriousness of the situation but awareness is important here too, because:

“Incident reports suggested that when ingestion was reported, healthcare staff did not recognise the need for this to be treated as a medical emergency.“

Consumer action
Put pressure on manufacturers and designers to include locked or otherwise tamper-proof compartments in their designs to make it much harder for children to get at the batteries. Chitra’s paper also suggests liaising with any professional bodies (in her case audiologists, raising awareness by publishing in the British Academy of Audiology’s journal).

Alternative solutions
In addition to locked compartments people are also looking at ways of preventing harm when a battery is swallowed by adding a protective coating that prevents them from creating an electrical current. One example is from MIT: New way to make batteries safer (3 November 2014)

CHI+MED’s recommendations

Awareness of the risks and their seriousness is needed among many different people.

Parents, carers and healthcare staff need to know that battery ingestion is a medical emergency and that follow-up care may be needed for several weeks. Unexplained symptoms of coughing up or vomiting blood and respiratory difficulties may indicate battery ingestion (perhaps unwitnessed).
Mistaken beliefs about battery ingestion needs to be challenged: some healthcare professionals have considered that “battery ingestion would be harmless unless the battery was damaged or leaking” (NHS England 2014) however it is the electrolytic effects that can cause catastrophic damage.
Near-miss incidents with batteries need to be systematically recorded with an opportunity to learn from these and share learning across departments (audiology, gastroenterology, A&E) as well as with manufacturers.
Information needs to be communicated, by parents and healthcare professionals, to hearing aid designers so that they can ‘design out’ this risk by fitting locks.
Regulators need to incentivise marketing of products which have tamper-proof battery locks.