Sunday 18 August 2019

Call for new safety standards to prevent deaths from button batteries

An X-ray showing a lithium button battery that was swallowed by a child
An X-ray showing a lithium button battery that was swallowed by a child

Josie Clarke

The death of a child who swallowed a button battery has led to recommendations for new safety standards and guidance for emergency health workers.

A report from the Healthcare Safety Investigation Branch (HSIB) in the UK has recommended a government strategy to improve button and coin cell battery safety, including a standard covering their design, product casing, packaging and safe retailing practices.

Paramedics and other health professionals should also have support and guidance to spot the signs of a swallowed button battery.

The HSIB's report follows the death of a three-year-old girl after she swallowed a 23mm battery in the run-up to Christmas 2017.

The report details the parents' constant efforts over days to seek treatment for the child, who was initially diagnosed with tonsillitis and prescribed antibiotics.

Further visits to the family GP and local hospital followed, resulting in more antibiotics. Three days later, after a second call that day to 999, the girl died after she was taken by ambulance to hospital.

The HSIB said the case highlighted the significant risk to under five-year-olds from swallowing the batteries, which can become lodged in the oesophagus (food pipe) and cause a chemical reaction on coming into contact with fluid that erodes tissue in just two hours.

The report said the severity of harm caused by such batteries - commonly found in toys, remote controls and car fobs - becoming lodged in a young child's oesophagus was not widely understood by the public.

READ MORE: The common causes of choking... and how to help someone who is

The HSE warns that if you think your child has swallowed a button battery, bring them immediately to your nearest hospital emergency department (A&E) that admits children.

The HSIB warned that small children are at higher risk due to their tendency to put things in their mouths, and people should be particularly vigilant to button batteries with a diameter of 20mm or more as they are more likely to get stuck in the throat.

More information on button batteries and their dangers can be found on the Child Accident Prevention Trust website.

HSIB chief investigator Keith Conradi said: "In this instance, we are not just putting the onus on public safety awareness but also looking at what can be done before products reach homes and what clinical staff need to be aware of to make the right diagnosis.

"As we've seen in our reference case, the consequences of a child swallowing a button/coin cell battery can be devastating. We've worked closely with national organisations to ensure our safety recommendations help prevent this happening to other families."

British and Irish Portable Battery Association chairman Frank Imbescheid said he welcomed the report.

He said: "These batteries are increasingly being used in many household essentials making everyday life more convenient.

"However, as they are more powerful than alternatives, it is important that consumers have the right information and advice to be able to keep their children safe.

"The portable battery industry remains committed to working collaboratively on this issue; whether that be on safety standards to improve child resistant packaging, placing warning icons on such batteries, or investigating new technologies and design and providing education materials in partnership with Child Accident Prevention Trust."

Professor Derek Burke, a consultant in paediatric medicine who advised the investigation team, said: "Treatment and management of children under five even when a button/coin cell battery is suspected or known is a major challenge for frontline clinicians.

"This is made even harder when unknown due to the nature of symptoms and other conditions that need to be considered.

"The HSIB report shines a light on this issue and the recommendation made to the Royal College of Paediatrics and Child Health will help to support this decision-making process, especially when clinical staff are in a busy environment and faced with time critical decisions."

The responses to the recommendations will be published on the HSIB website later this year.

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