Lithium Manganese Button Battery
Button batteries power hearing aids, wristwatches and other small devices. They have a low self-discharge to hold their charge for long storage and service life.
Battery ingestion can be a serious choking hazard for young children and adults. Call the Poisons Information Centre on 13 11 26 (local call rates from land line only) if you suspect a battery has been swallowed.
Safety Warning
Button cell or coin batteries, including lithium, zinc silver, and manganese button cells, are a serious choking and burn hazard for small children. If ingested, they can cause burns to the inside of a child’s nose or ears, and in rare cases, death.
A number of incidents involving ingestion of lithium coin cell or button batteries have occurred among young children. In one case, a child swallowed a 20-mm lithium battery and died 19 days later. The battery lodged in the oesophagus and caused serious burns to the surrounding tissue. In another case, a child ingested a 12-mm battery and developed an intestinal obstruction.
The CPSC is currently developing rules and regulations to address this hazard. These proposed regulations are intended to prevent button cell and coin battery ingestions by requiring safety warnings on batteries included with consumer products, warnings on spare batteries that are installed within a product, and performance standards for battery compartments that ensure batteries do not become accessible to children after use and abuse.
For batteries not yet installed in a consumer product, the packaging of such batteries must contain a warning label and icon. The battery packaging must comply with the formatting requirements of Table 12; if space does not permit the full warning to be displayed, it must include the icon shown in Figure 4.
Having this information will remind consumers that buttons cell or coin batteries are a serious ingestion hazard and encourage them to keep these batteries out of reach. They will also be more likely to take appropriate action to store spare batteries safely away until they are installed in a consumer product.
When a button battery is ingested, it can cause Internal Chemical Burns that may lead to death in as little as 2 hours. The Poison Center states that this type of ingestion hazard occurs more frequently in children than in adults, and that people with hearing aids are more at risk of this hazard.
If a battery is ingested, seek immediate medical attention and call the Poisons Information Centre on 13 11 26 (local call rates from land line only). Do not give any food or drink to the person who has ingested a battery.
Common Complications
The lithium manganese button battery is a dangerous battery that can cause serious complications. It has a high risk of injuring the esophagus and stomach. It is also potentially harmful to the environment as mercury from this battery may escape into the air and contaminate groundwater.
The most common type of complication is a battery that lodges in the esophagus, especially a 20 mm diameter lithium coin cell (like a U.S. penny or nickel). Smaller cells are less likely to lodge, but they can still cause injury.
A lithium battery in the esophagus can cause severe burns and tissue damage within 2 hours of ingestion. It can also cause necrosis of the mucosal lining and even ulcerations if it stays in the esophagus for an extended period of time.
These injuries can occur anywhere in the esophagus, including the mouth, neck, and the back of the throat. If you suspect a battery ingestion, immediately obtain an x-ray to locate the battery.
If the battery is not easily recognizable, consider obtaining an AP radiograph and lateral view. Observe the battery for usb rechargeable battery its double-rim or halo effect on the anteroposterior radiograph and its step-off on the lateral film.
For patients 12 years, have them examined urgently for signs of battery ingestion, including: wheezing; coughing or hoarseness; drooling; vomiting; chest pain or discomfort; abdominal pain; difficulty swallowing; or decreased appetite or refusal to eat. It is also important to look for other foreign body gastrointestinal symptoms, such as: fatigue; dizziness; nausea or vomiting; or difficulty urinating.
X-rays are important to help guide therapy. If a patient’s swallowed battery is not easily identifiable or if it has remained in the esophagus for more than 24 hours, endoscopy may be necessary to remove it.
A case of a 3-month-old infant was recently reported with a lithium battery that had firmly lodged in the antrum. The battery was surrounded by necrotic debris, and endoscopic removal failed.
Lithium batteries have a higher risk of complications than alkaline batteries because they contain more power and larger cells. They generate an external current that can electrolyze tissue fluids and produce hydroxide at their negative pole.
Signs of Complications
Button batteries are a type of rechargeable battery used in many different types of portable consumer electronic devices. They contain an electrochemical system with metallic lithium as the anode and a small amount of manganese dioxide (MnO2) as the cathode. The batteries come in various sizes and are available in a variety of case shapes.
They have an average life span of about 3,000 to 4,000 charges and require up to 0.15 kg of lithium to produce a single kilowatt-hour of power. The batteries are made in a wide range of voltages and current capacities.
The most common complication of a button battery is injury to the esophagus or other parts of the gastrointestinal tract. These are especially serious in young children and can result in permanent damage to the esophagus, stomach, and intestines.
These complications can be life-threatening and include tracheoesophageal fistulas, pyloric stenosis, and severe esophageal tissue necrosis. Early detection, prompt treatment, strengthening observation, and regular follow-up after discharge are important for improving outcomes.
Patients with large button batteries (20 mm diameter) are more likely to develop esophageal injury and complications than those who have smaller button batteries. Therefore, it is recommended to obtain an x-ray to locate the battery in these patients before performing a laryngoscopy.
In addition, patients with a large button battery should be observed for vocal cord changes or signs of respiratory distress. Unilateral or bilateral vocal cord paralysis is a common complication of ingesting a button battery and should be considered in the evaluation of these patients.
Although there are some cases in which a button battery has been removed without causing significant complications, it is not uncommon for these batteries to lodge in the esophagus for long periods of time. They may cause a rapid onset of esophageal mucosal injury that can lead to a choking episode and stridor.
This is because the acidic environment of the esophagus causes the seal or crimp of the battery to erode, allowing contents to leak out. The chemical content of the battery is released in the esophagus and can cause a burning sensation, which can be very dangerous to the patient.
Treatment
Lithium manganese batteries are used for portable electronic devices such as power tools, medical equipment, and hybrid and electric vehicles. They are known for their low internal cell resistance and high discharge capacity. They are usually packaged in 18650 sizes and can be charged at currents up to 20-30A with moderate heat buildup.
They are commonly used in watches, calculators and hearing aids because they give good battery life. They are also recyclable because of their silver content.
However, they are a potential hazard when swallowed and can cause serious burns usb rechargeable battery if lodged in the esophagus. These batteries are also a serious choking hazard, especially for small children.
Ingestion of button batteries is a common emergency, affecting up to 12.6% of all children younger than 6 years of age. The most common complication is a button battery that is lodged in the esophagus, leading to severe injury and possible death.
The key mechanism of injury is mucosal contact between the electrode and the tissue, which leads to a flow of electrical current that induces generation of sodium hydroxide in tissues. This results in local tissue hydrolysis and liquefactive injury with an increase in tissue pH.
This alkalotic liquefactive damage persists hours after the battery is removed and can lead to further tissue breakdown. It is recommended that a time-critical endoscopy should be performed to remove the impacted button battery and prevent further complications.
Another option is to use a neutralising agent during removal of the impacted battery, based on research that this effectively decreases tissue pH and mitigates the severity of the injury. A recent study has shown that acetic acid used topically at the time of button battery removal is effective in mitigating the injury and can reduce the likelihood of long-term sequelae [4].
Early diagnosis of impacted button batteries is critical, as a battery that remains in the esophagus can lead to gastrointestinal tract blockage, potentially causing life threatening complications. Prompt endoscopic removal is the most effective treatment to prevent these life-threatening complications.