Ingestion or exposure to a battery, especially the small, coin-shaped lithium variety, is a medical emergency requiring immediate professional intervention. These items pose a severe and rapid threat to a child’s internal tissues. Time is a limiting factor in preventing permanent injury once a battery is placed in the mouth or swallowed. Parents and caregivers must treat any suspected or witnessed battery contact as an urgent situation, even if the child shows no obvious distress, as acting quickly can prevent a life-altering injury.
Immediate Emergency Response
Call a medical professional immediately, without delay, even if the child appears completely fine. In the United States, parents should call the National Battery Ingestion Hotline at 800-498-8666 or the National Poison Control Center at 1-800-222-1222 for guidance while preparing to travel to the nearest emergency department. Provide information about the battery type, estimated time of ingestion, and the child’s age.
If the battery is visible in the child’s mouth, gently and carefully remove it. Avoid forcing fingers down the throat, which could push the battery further down the airway.
If the child is over twelve months old and the battery was swallowed within the prior twelve hours, administer two teaspoons (10 mL) of honey every ten minutes while en route to the emergency room. This measure helps coat the esophagus and slow the chemical reaction, but it is not a substitute for immediate medical care.
Never attempt to induce vomiting, as this risks lodging the battery or causing a second corrosive injury. Unless specifically instructed otherwise, do not give the child any food or liquids, including water. The goal is immediate transport to the hospital for an X-ray, as a battery lodged in the esophagus requires urgent surgical removal.
How Batteries Cause Severe Internal Injury
The danger posed by button batteries, especially those 20 mm or larger, stems from a unique electro-chemical reaction when they lodge in moist tissue, such as the esophagus. When the battery is held against the esophageal wall, saliva completes an electrical circuit between the battery’s poles, causing the current to rapidly hydrolyze surrounding tissue fluids.
This process generates hydroxide ions at the negative pole, creating a highly alkaline environment with a pH that can climb as high as 12 or 13. This causes a severe, caustic chemical burn known as liquefaction necrosis, which dissolves the tissue and allows the burn to penetrate deeply into the esophageal wall.
Damage can begin in as little as fifteen minutes, and serious burns can occur in just two hours. Potential complications include perforation, vocal cord paralysis, or erosion into major blood vessels.
While the electrical current is the dominant mechanism of injury, pressure necrosis and, to a lesser extent, the leakage of alkaline electrolyte contents also contribute to damage. Even batteries considered “dead” still retain sufficient residual voltage to create this powerful electrolytic reaction.
Signs That Injury Has Occurred
Symptoms following battery ingestion are often non-specific and may be mistaken for a common cold, leading to dangerous delays. Parents should watch for any sudden onset of unexplained symptoms, especially those related to the throat and breathing.
Common indicators include drooling, difficulty swallowing, or a sudden refusal to eat or drink. Respiratory distress may also occur, such as coughing, wheezing, noisy breathing, or gagging when consuming liquids. Other signs include chest or abdominal discomfort, vomiting, or a low-grade fever. Severe, late-stage symptoms include vomiting blood or passing blood-tinged stool.
The absence of immediate symptoms does not mean the child is safe. While the battery may move freely through the digestive tract, the only way to confirm this is through a medical evaluation and X-ray. Any suspicion of ingestion requires an immediate trip to the emergency room, regardless of the child’s apparent condition.
Securing Batteries and Preventing Exposure
Proactive measures are the most effective way to prevent life-threatening injuries associated with battery exposure.
Storage and Accessibility
- All loose batteries, especially coin-sized lithium cells, should be stored in their original child-resistant packaging or placed in a high, locked cabinet.
- Keep batteries separate from medications, as small button batteries can be mistaken for pills.
Device Audit
- Perform a home audit of all devices that use button batteries, such as remote controls, flameless candles, key fobs, and musical greeting cards.
- Ensure every device has a secured battery compartment that requires a tool, like a screwdriver, to open. If a compartment is not secure, use strong tape to seal it shut.
Disposal
Proper disposal of used batteries is necessary, as even “dead” batteries retain enough residual charge to cause severe caustic burns if ingested. Used batteries should be wrapped securely and immediately taken to a recycling center or discarded in a way inaccessible to children. Avoid changing batteries in front of small children, as this can pique their curiosity.