The number of ED visits among children who swallow batteries or insert them into their nose or ears doubled over the past 20 years, according to data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System. Small button batteries were involved in 84% of the cases, and about three-quarters of children were younger than five years old. Although the most common sources of the batteries were toys and games, children also often retrieved batteries from other common household products.

On average, 3,289 ED visits annually were battery related, or one visit in the United States every 2.66 hours. The number of battery-related ED visits jumped from 2,591 in 1990 to 5,525 in 2009. This parallels a similar increase in the use of 3-V, 20-mm lithium batteries in household products.

The mean age of children seen in EDs for battery-related problems was 3.9 years, and 60% were boys. Children younger than one year made the most visits. The batteries came from toys (29%), hearing aids (16%), watches (14%), calculators (12%), flashlights (9%), and remote controls (6%). A swallowed battery was the most common reason for a visit (77% of the time), followed by insertion into the nose (10%), mouth (8%), and ear (6%). The majority of children (92%) were treated and released, and no fatalities were reported, although the researchers note that the database doesn't capture fatalities well.

Most batteries pass through the body without problems. However, a button battery can lodge in the esophagus and cause serious injury in less than two hours. Button batteries generate an external electrical current that burns tissue. "If a family suspects a child swallowed a battery, they should get the child to the ED immediately because the clock is ticking down," says coauthor Gary Smith, president of the Child Injury Prevention Alliance at Nationwide Children's Hospital in Columbus, Ohio. Triage by ED nurses is vital, so the child can undergo surgery or another appropriate treatment as quickly as possible.

Nurses play an important role in educating families on the dangers of button batteries and preventive steps they can take, such as taping shut the battery compartments of all household gadgets, not just toys, Smith told AJN. Ideally, products should be designed so that battery compartments require a screwdriver or other tool to be opened.-Carol Potera

Reference