By Vicki Louk Balint
If your child swallowed a small, single-cell battery, how would you know?
You might think that a small child would show signs of choking if they’d ingested a small object. But that’s not always the case, says NextCare Urgent Care CEO Howard Podolsky, M.D
The child may still be able to speak, or cry, because these “coin” or “button” batteries—used in small electronic devices like toys, remotes, greeting cards or hearing aids—may not be obstructing airflow from the windpipe.
“It may be extremely uncomfortable, it may even be lodged in there so that liquids cannot pass,” says Podolsky. “The child may vomit, may be uncomfortable—you may think flu.”
The batteries do not usually cause problems unless they become lodged in the gastrointestinal tract, nose or ears. The most common area of the body where cell batteries can become lodged is the esophagus. The current produced by the battery generates sodium hydroxide, a caustic, corrosive chemical. Experts say damage to delicate tissues can occur in as little as two hours, and can perforate an esophagus in less than six hours.
Karla Rauch, of Peoria, knew her son Emmett was very sick the day before his first birthday. The sitter called with the news that Emmett seemed to be running a fever. He just wasn’t himself that morning, Rauch recalls.
The family had no idea that he had swallowed the battery in the DVD remote they later found under the sofa.
“He didn’t want to eat,” says Karla. “I was trying to get him to eat, and his esophagus was burning away and he couldn’t tell me.”
It took an urgent care center visit, a trip to the pediatrician and a stop at a local emergency room over the course of a couple of days before Emmett finally ended up in surgery at Phoenix Children’s Hospital.
“I felt sick, devastated, guilty,” Karla says. “I didn’t remember a choking episode. That is what blew my mind. All these haunting feelings took over. I’m a mom—how did I not know?”
When a battery is swallowed, it can burn the esophageal wall just by touching it, says J. Craig Egan, M.D., a pediatric surgeon at Phoenix Children’s. He says he sees three to five children per month who need care after swallowing a button battery—an increase over the last few years. The non-profit safety coalition Safe Kids USA reports that in 2010 alone there were more than 3,400 cases nationwide of children swallowing the coin-sized batteries.
In most cases, children are not diagnosed right away because parents are unaware their child has swallowed a battery, says Egan. Pediatricians don’t order X-rays on every child who comes in coughing.
Patients “may just have an upper respiratory infection or something that doesn’t require an X-ray,” says Egan. If a child has symptoms, parents should look around their home to see if a device is missing a battery. That information may help to confirm a doctor’s suspicion of a possible foreign object ingestion that justifies ordering an X-ray.
Egan performed a nine-hour surgery to start the repair process on Emmett’s esophagus. “It was a miserable week,” says Michael, Emmett’s dad. “He couldn’t sleep or eat. At first, when Karla told me what had happened, I thought, worst-case scenario, we’d be in the hospital a day or two; he’d have a sore throat a couple of days. I assumed that was the plan of action. But things just got worse and worse.”
It was a major setback for Emmett, now 2, who was born prematurely and had required surgery as a newborn. (In a twist of fate, it had also been performed by Egan.) Several surgeries and long hospital stays over the past year to help restore Emmett’s health have been difficult for the family, but they are hopeful.
“You hear of other people having accidents, but you never think it’s going to happen to you,” says Karla. “But we need to stay positive if we want Emmett to fight.”
Egan says that as a father, an awareness of these batteries and the devices they power has intensified.
“I do not want to see them sitting on a counter, I do not want to see anything that contains them sitting on the floor in the reach of young children. Families should be aware that things that older children play with can be left on the floor or within reach of the babies. It’s not intentional, but it’s a risk. Even seniors can mistake them for their medication.”
If you suspect that your child has ingested something, see a medical professional without delay and be ready to provide detailed information, says Podolsky. Be aware of devices that contain small-cell batteries, and keep them out of reach of small children.
“As a physician, you do the best you can with collateral history-taking,” he says. “I’d rather deal with anything at an early stage. It’s always better to deal with a minor issue before it becomes a mountain.”