Monday Medical: Keep those lithium batteries away from kids
December 24, 2012
Steamboat Springs — Santa Claus has now made his list and checked it twice. Once so that young children get just what they want. Twice to ensure that all toys with lithium ion batteries are well marked.
Parents, grandparents and other gift-givers should know there has been a disturbing and growing incidence of infants and children ingesting small, lithium batteries — the kind frequently found in toys but also in remote controls and musical greeting cards.
Bite-sized batteries attract babies
As electronic toys and gadgets have become increasingly miniaturized, batteries have become more high-performance and compact (i.e. bite size). Small, smooth, disc-shaped or pill-shaped, these batteries appear tasty to a toddler. Since 1985, there have been more than 8,100 cases of battery ingestion with 13 reported deaths.
Choking is the fourth leading cause of death in children, just behind motor vehicle injuries, drowning and fires. Most parents are aware of choking hazards in younger kids, especially those younger than 4. Toddlers and infants have not yet mastered the sophisticated sequence of chewing, swallowing and breathing in a coordinated fashion. That means that nuts, seeds, raw carrots, hard candies or other hard-to-chew foods should be avoided. Large chunks of apples and tubular foods that fit perfectly into the larynx (voice box), like hot dogs and whole grapes, should be cut up before given to toddlers.
Non-food items that present the greatest choking hazards include batteries, balloons, coins, small toy parts, pen caps and marbles. As a result of efforts by the Consumer Product Safety Commission, all toys that fit within a small-parts test cylinder of 1.25 inches must be labeled "For children over 3 years."
More than a choking hazard
But lithium-ion batteries pose more than just a choking hazard. They produce a toxic discharge that can damage the esophagus (swallowing tube), or airway, within hours after reported ingestion. Their invasive corrosiveness requires urgent removal because any time taken to image with X-rays, track the progress of the battery through the alimentary tract, or wait for clinical signs to emerge can dramatically increase the amount of damage done. If a toddler swallows a penny or a small coin, watchful waiting until it passes is a reasonable option in an asymptomatic child. This is not an option with lithium batteries.
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Batteries lodged in the esophagus ideally should be removed immediately. They cause tissue injury in as short a time as one hour and can cause a hole in the esophagus in four hours. Batteries passing through the esophagus will usually travel through the digestive tract eventually.
Signs of battery swallowing
A child who has ingested a lithium battery may have one or more symptoms:
- Persistent drooling
- Abdominal pain
- Dark or bloody stool
If you suspect a child has swallowed a lithium battery, proceed to the nearest emergency department. To protect young children, be aware of which electronic devices in your household contain lithium batteries. Secure battery compartments in electronic devices should be properly secured and taped shut. Store all batteries in child-proof containers.
If you're still thinking about Santa's list, think about safety first. How about a yo-yo or a children's book?
Maryann Wall, M.D., is board certified in otolaryngology — head and neck surgery and facial plastic and reconstructive surgery. Her office is on the campus of Yampa Valley Medical Center in Steamboat Springs. She can be reached at 970-879-3200.