Clinical features, management, and complications of paediatric button battery ingestions in Canada: an active surveillance study using surveys of Canadian paediatricians and paediatric subspecialists.

Abstract

Background: Button battery ingestions pose a serious threat to paediatric health and are on the rise worldwide. Little is known about Canadian data. This study described the type of button battery ingestions Canadian paediatric physicians have observed, including treatment and complications.

Methods: A Canadian Paediatric Surveillance Program (CPSP) survey was sent to paediatricians and paediatric subspecialists. The questions were developed through a literature review and consultation with 19 CPSP members, before piloting with 5 paediatric physicians. Descriptive analyses were conducted.

Results: The response rate was 39% (n = 1067/2716). Few were aware of treatment options with honey (n = 189/1067, 18%) and sucralfate (n = 118/1067, 11%). Two hundred and ninety-nine physicians (28%) had been involved in a case in the past 1 year (n = 132 case details). Children < 3 years were most affected (n = 67/132, 51%). In unwitnessed ingestions (n = 41/132, 31%), the most common symptoms were dysphagia (n = 14/41, 34%) and coughing (n = 10/41, 24%). When it was known where the child found the battery, it was most commonly loose in the environment (n = 34/132, 26%). Seventy per cent of patients (n = 92/132) presented within 6 h following the ingestion. Six per cent (n = 8/132) reported the battery eroding into important adjacent structures (eg, aorta and trachea).

Interpretation: A high degree of suspicion for button battery ingestion is needed in young children presenting with dysphagia and coughing. Prevention efforts should be aimed at battery disposal and security. There is a need for dissemination of guidelines to physicians caring for paediatric patients, since modifiable patient factors, such as honey and/or sucralfate administration while awaiting definitive treatment, can improve outcomes.