Beware button battery risk

We give you see to real story In a small town in eastern Turkey, my friend's 10-year-old brother was playing a silly game of keep-away with his sister. He was hiding a small disc battery and she was trying to find it. Because she was clever and kept finding the battery in even his best hiding places, he got the idea to pop it in his mouth – she'd never find it there. While he was trying to maneuver the battery under his tongue, lest she get the idea to look in his mouth, it slid to the back of his throat and immediately lodged there. The clock for this young boy's life began ticking at that moment and, less than a week later in the ICU, doctors are still not sure if he'll survive. An innocent-looking toxin

ШУУД ҮЗЭХ

Most people think that locking household chemicals and medicines away is sufficient to childproof your home. Think again! The danger of coin lithium button (or disc) batteries is very real and on the rise. Many manufacturers of toys and devices do not childproof the battery access, and even if they do, dropping a device or toy on the floor and breaking it can cause the battery to be released. Young children May also put the small batteries up their noses or in their ears. Battery manufacturers are starting to put warning labels on their packaging, but most people don't even see them – batteries have been around for years and most people don't consider them to be dangerous. In addition to the dangers to children, elderly people can mistakenly ingest batteries (like tiny hearing-aid batteries) after having placed them into a small pill case for safekeeping. When it's time to take their medicine, they inadvertently ingest a battery instead of a pill. Some adults have also accidentally ingested disc batteries while holding the battery in their mouths in the process of replacing watch or hearing aid batteries. Incidents on the rise According to the American Association of Poison Control Centers, this boy's story is becoming more common: The number of ingestions of disc batteries has increased more than 80 percent from 1998 to 2006, and the statistic continues to rise. The reason for the increase is that disc batteries become more and more necessary as toys and other devices continue to shrink in size. They can be found in greeting cards, remote control devices, key fobs -- any small, battery-operated devices. Children typically get their hands on these discs from the devices themselves, not from batteries lying around the house. Time wasted At first, nobody believed my friend's brother. He had always been a trickster, pulling pranks and teasing people at every opportunity. He was the Boy Who Cried Wolf, but after 20 minutes, everyone realized that something was indeed wrong. His condition seemed serious; they took him to the local doctor. The doctor took an X-ray and proclaimed there was nothing there, but as the boy was in distress, the doctor gave him some serum -- the first step taken in many hospitals. After two-and-a-half hours of serum, and with the boy not getting any better, the doctor sent him to the closest hospital, about 30 minutes away. The family jumped in a taxi and sped to the hospital where the boy waited for two hours before a doctor would see him. Time is not on your side If you even think a child has swallowed a battery, act fast. Generally, children and adults who swallow batteries can safely pass them, but in some cases, especially with the larger-sized disc batteries, they can lodge in the esophagus. If the battery is not removed early, the first damage that can occur is in the form of a burn. Injury can occur in as little as one hour, and full-thickness burns -- burns that are the full depth of the esophageal tissue -- can occur in as little as four hours. In this case, the boy sustained chemical burns on the esophageal wall due to battery acid leaking out and electrical burns caused by the current generated by the battery. Severe bleeding can occur and/or fistulas (connections/holes in the esophagus) that can cause the damage to spread to other parts of the body. In his case, he has a fistula in the esophagus that may be in contact with his heart. In addition to burns, heavy metals such as mercury in some batteries can serve as a secondary poisoning, causing chemical brain damage. In this boy's case, it's too soon to know the extent of the damage. Home care Ingestion of a disc battery is a serious medical emergency. The first step if you think a child has swallowed a disc battery is to withhold food and water and immediately get to the nearest emergency room. Do not induce vomiting. If you know what kind of battery was ingested, bring a sample or the package with you so the doctors can look up the battery code to determine the manufacturer, the battery's size and its contents. If you do not have an extra battery or battery packaging, then bring in the toy or device in which the disc battery was placed so that doctors can determine the size and possibly information about the manufacturer or the contents of the battery. An excellent resource for assisting in battery identification and emergency home care instructions is the National Button Battery Ingestion Hotline, (202) 625-3333. My research did not turn up a similar hotline number in İstanbul -- not even a poison control number. Evaluation At the hospital, doctors perform radiographic studies to determine where a battery may be lodged. If they are unable to find the battery, they may take pictures of the entire digestive system. Through such analyses, doctors can determine whether a disc battery or other circular item was swallowed -- an easy determination because disc batteries have unique characteristics: They give off a two-layered shadow versus a singular layer that might be seen with coins, toy discs or buttons. If the battery is lodged in the body, especially the esophagus, it must be removed immediately to prevent severe harm. When the hospital doctor looked at the boy's X-ray, he easily found the disc battery. However, the hospital was not equipped for the operation needed to remove the disc, so they sent him by ambulance to another hospital, this time in Diyarbakır, four hours away. On the way, the disc burst and began burning his esophagus. When he got to the second hospital, he was rushed into the operating room. Doctors worked for nine hours to get the battery and all the poison out. Eight hours later while he was in ICU, they discovered that they had missed some of the particles and so they operated again. The time that passed from ingestion to possibly having removed all toxins – still largely unknown at this point – was over 24 hours. The doctors involved along this boy's journey did not seem to have the training or an awareness of the seriousness of the situation. Most emergency room doctors don't have specific training in otolaryngology, so they may not know how and/or might not have the equipment available to scope a patient to find and remove a battery before it's too late. They also might not know how to evaluate for certain heavy metals. Treatment If the disc battery can be removed from the esophagus, it is typically done with the help of an endoscopy: Doctors may be able to observe and then remove the battery from the esophagus. If not, surgical removal is the next option. However, as this boy's story highlights, surgical outcomes are conditional and dependent upon the amount of time that the battery stays in the body and the consequent damage that occurs. A cautionary tale Now, lying in intensive care, the young boy awaits his fate. His doctors say that this type of accident is fatal 80 percent of the time. Next to him, a man dies, and the man's family screams and wails. He looks to his older brother and asks, “Abi, am I next?” I write this story as a cautionary tale. Parents beware -- those little batteries that power toys, watches, laser pointers or other small electronic devices are as fatal as the bleach or other cleaning chemicals you have locked away from your child's reach. When you are childproofing your home, make sure that loose batteries are locked away and that batteries in devices are secured. I don't know what will happen to my friend's little brother. Doctors say he may be in the intensive care unit for more than a month. They don't know if he will live. If he lives, they don't know if he will ever be able to swallow again without pain. Please help me turn this child's tragedy into a meaningful lesson of prevention by spreading the word about this danger.