St. John's Mom

The following is from HSW - did you know that if a button battery is swallowed, severe injury can occur within 2 hours of ingestion? These little things are everywhere these days - cards, candles, ornaments, watches, etc. This article is a reminder to be extra vigilant!

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Health Canada and other health authorities report that cases of people swallowing button batteries reported to manufacturers and health officials that result in serious internal injury and death are on the rise. These small disc-shaped button batteries store lots of energy in a tiny space. They are commonly found in a wide range of products around the home that children have access to, such as remote controls, musical greeting cards, watches, calculators, flashing jewellery and shoes, key fobs, books, and other small electronic devices.
The size, shape and energy storage properties of button batteries make them hazardous if swallowed. A swallowed button battery can block an airway or can cause serious internal chemical burns in the oesophagus in as little as two hours. The 20 to 25 mm diameter lithium button batteries result in the most serious injuries, especially where young children are involved. In cases of swallowing, the batteries were found loose on the floor by young children, in garbage bins, or on counter tops, taken directly from a package, or removed from household products. Even adults, particularly seniors, have unintentionally confused button batteries with pills or food and been injured.

Children who swallow "button" batteries, commonly found in toys and consumer products around the home, can suffer internal injuries within two hours of ingesting one, according to a recent U.S. study. 
A review of button battery safety by the Winnipeg Regional Health Authority summarizes the risks and provides parents and caregivers with advice on what to do if a child swallows a battery or places one in the ear or nose, and how to best protect children from small batteries. Highlights of the WRHA article and the original US study are provided here.

A U.S. study reported that in the past 18 years there have been over 8,500 cases reported to the American Battery Ingestion Hot line, with 73 cases of serious injuries from battery ingestion and 13 deaths. Sixty-two percent of these cases occurred in children who were younger than 6 years of age. Injuries (e.g., severe burns, esophageal stenosis, bilateral vocal cord paralysis) occurred as soon as 2 hours after ingestion. The study also found that at least 27% of serious outcomes and 54% of fatal cases were initially misdiagnosed, usually because of nonspecific presentation.

Injuries typically occur when a battery becomes stuck in a child's oesophagus. Once lodged, the battery can create an electrical current that burns the surrounding tissue. Children have also put small batteries in their noses and ears. This can also cause a burn and so they need to have the battery removed immediately. Button batteries that are not removed and remain in the oesophagus can cause burns and even perforation of tissues, causing life-threatening and sometimes fatal injuries.Depending on where the battery is lodged, it may be removed either using a scope or surgery.

"Our advice is to go immediately to go to Emergency and have an X-ray taken. If the battery is in the oesophagus, it needs to be removed as soon as possible," says Dr. Lynne Warda, a medical consultant with Impact, the Winnipeg Health Region's Injury Prevention Program.

Button batteries do not all pose equal risk. The smaller batteries may be ingested and passed without a person knowing it. It's the bigger ones that are more likely to become lodged and cause permanent tissue damage - or even death.
Parents are encouraged to look for toys that help protect children from batteries by having a compartment for the battery that may only be accessed with a tool or screwdriver. But button batteries are everywhere. A glance around your house will show the common ways they may be found, in household products like remote controls, garage door openers, cameras, calculators, key chains, jewellery with flashing lights and even greeting cards. And they're much easier to access in these types of products.

WHAT TO WATCH FORChances are you may not see your child swallow a button battery. Parents who suspect that their child has swallowed a battery, should first ask the child where the battery is. If the child indicates that he has swallowed the battery or inserted in his/her nose or ear, the child should be taken to the Emergency Department right away.

There are no clear visible symptoms of battery ingestion. A child who has swallowed a battery may gag or choke, trying to cough it up. Older children may complain of discomfort when swallowing or a sensation that something is stuck in their throat or neck. Younger children may drool and refuse to drink.

If a battery is swallowed or placed in the ear or nose Act Quickly - don't wait for symptoms to develop. If the battery was swallowed, don't eat or drink until directed by a physician.

Batteries stuck in the ear, nose, or oesophagus must be removed as quickly as possible as severe damage can occur in as little as 2 hours.
20 and 25 mm lithium batteries can be identified by their imprint codes, CR2032, CR2025 or CR2016, which are located on the face of the battery.

HOW TO PROTECT YOUNG CHILDREN•Store spare batteries safely out of a child's reach. Never leave them sitting out, even if they are in their original package.
•Check all electronic household products to see that the battery compartment cannot be easily opened by a child.
•When purchasing products, look for those that require a tool or screwdriver to access the battery compartments.
•Don't allow children to play with batteries or take toys with batteries to bed.
•Educate family members who wear hearing aids about the hazards of small batteries to children. Help them find safer ways of handling and disposing of the batteries.
•Supervise children when they use products containing button batteries, such as musical greeting cards, remote controls, books, flashing jewellery and other small electronic devices.
•Scan floors, tables and counters for loose button batteries.
•Dispose of button batteries so that children cannot gain access to them.

WHO ELSE IS AT RISK?With the elderly, poor vision may contribute to mistaking the button batteries for other objects - a hearing aid, medication or food, for example. A surprising 15% of people who ingested a button battery mistook it for a pill, according to a US study. There are accidental reasons adults may ingest button batteries - using your mouth to hold a battery, putting the battery in a glass that you drink out of before properly disposing of it and drinking from the glass to name a few. Store button batteries away from food and medicine. Take care when changing the button batteries in a product that they do not get mixed in with any pills, medicine or food. Realize that to anyone with poor eyesight, button batteries look just like pills or candy.

Battery facts at a glance

•The 20mm button batteries are the most hazardous.

•Top three sources of ingested button batteries: hearing aids or cochlear implants, games or toys, and watches.

•According to a recent US study, 13 deaths have been reported. In other serious cases, children under four years of age required medical follow-up because of compromised feeding and/or breathing and required multiple surgeries, tube feedings and/or tracheotomies.

•Of the batteries ingested by young children, 68% of them were obtained from products (rather than found loose or still in the package).

•The rate of major or fatal outcomes from ingested batteries in the U.S. was 6.7 times higher in recent years (2007-2009 compared to 1985-87).