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MUSC Health Blog

Keyword: children
Dr. Clemmens

Guest Post by:
Clarice Clemmens, M.D.
MUSC Children's Hospital
Pediatric - ENT

Summary: 

The number of button battery ingestions resulting in severe injury or death has increased dramatically over the past thirty years. Rapid diagnosis and treatment are critical in preventing extensive injury, and close follow-up is required as delayed complications can occur weeks to months after button battery removal.

Article:

Within the pediatric population, the swallowing of foreign bodies is a commonly encountered situation, particularly in those children aged 0 – 5 years. While the ingestion of many foreign bodies can be managed on a non-emergent basis, the ingestion of button batteries results in rapid and often catastrophic injuries. From 1985 – 2009, a 6.7-fold increase in the percentage of button battery ingestion with severe and fatal outcomes has been reported, with outcomes notably worse in children younger than 4 years old. Button batteries are ubiquitous, and their ingestion has become an increasingly encountered emergency associated with the increasing use of 3V 20-mm Lithium button batteries. Recent legislation now requires that toys have a compartment with a screw to contain button batteries, however, button batteries are also found in many less secure household items. 36.2% of reported cases of 20 mm lithium battery ingestions were from remote control devices, with a significant percentage of batteries also intended for watches and stopwatches, flameless candles, bathroom and kitchen scales, key fobs, and singing greeting cards. While batteries less than 15 – 18 mm in diameter generally pass through the esophagus and rarely require removal, the large size of the 20 mm batteries results in a propensity to become lodged within the esophagus, and the increased power results in more severe injuries. In fact, 94% of severe injuries or fatalities related to battery ingestion involved batteries greater than 20 mm in diameter. button battery

Button batteries produce injury by three mechanisms: (1) the generation of an external electrolyte current resulting in electrolysis of tissue fluids and the generation of hydroxides at the battery’s negative pole, (2) leakage of alkaline fluid, and (3) pressure necrosis. The generation of current is the primary mechanism by which button batteries cause injury. This mechanism is particularly important in the case of 20 mm lithium batteries, as these batteries do not contain an alkaline electrolyte and generate twice the current. These injuries occur rapidly, within two hours of ingestion, and are serious or fatal in up to 13% of cases.

Foreign body ingestions are often unwitnessed, and the symptoms of button battery ingestion are often nonspecific. They include cough, fever, decreased oral intake, difficulty swallowing, sore throat, and vomiting. These nonspecific complaints often result in a delayed diagnosis and further injury.  X-ray imaging is essential in diagnosing button battery ingestion.

Current National Battery Ingestion Hotline (NBIH) guidelines focus on a 2-hour window during which diagnosis and removal should be performed to minimize esophageal damage. Given the nonspecific nature of presenting complaints, it is imperative that health professionals maintain a high index of suspicion for button battery ingestion. Once the diagnosis is made, rapid removal of the battery within 2 hours results in the best outcome for patients and should not be delayed for any reason. Delayed complications occur often after removal of button batteries, sometimes presenting days to weeks after the initial insult. Therefore, close observation and follow-up after removal of a button battery is recommended.

So, the question remains: what can we, as parents, do to protect our children? Be aware. Be vigilant. Try to remove unnecessary items from your child’s environment that contain button batteries. Make sure that toys with button batteries utilize the required safety measures to avoid ingestion. And hide all spare button batteries in a place you are certain your children can never find. If you have the slightest suspicion that your child has ingested a button battery, treat it as a life-threatening emergency and have your child evaluated immediately. With increased awareness and prevention, we can hope to keep our children safe and avoid the often-devastating consequences of button battery ingestion. 

One in 3 children in the United States is overweight or obese. Childhood obesity puts kids at risk for health problems that were once seen only in adults, like type 2 diabetes, high blood pressure, and heart disease.overweight child

The good news is that childhood obesity can be prevented. In honor of National Childhood Obesity Awareness Month, MUSC Health encourages your family to make healthy changes together.

  • Get active outside: Walk around the neighborhood, go on a bike ride, or play basketball at the park.
  • Limit screen time: Keep screen time (time spent on the computer, watching TV, or playing video games) to 2 hours or less a day.
  • Make healthy meals: Buy and serve more vegetables, fruits, and whole-grain foods.

Taking small steps as a family can help your child stay at a healthy weight.

For more information, visit MUSCHealth.org.

Water Safety

Did you know drownings are the leading cause of injury death for young children ages 1 to 4? Three children die every day as a result of drowning. To keep children safe:

  • Always supervise children when in or around water. A responsible adult should constantly watch young children.
  • Teach kids to swim. Formal swimming lessons can protect young children from drowning.
  • Learn cardiopulmonary resuscitation (CPR). Your CPR skills could save someone’s life.
  • Install a four-sided fence around home pools.

The Charleston area offers many opportunities to get out on the water and recreational boating can be a wonderful way to spend time with family and friends. Make boating safety a priority when taking children out on the water.

  • Wear a properly fitted life jacket every time you and your loved ones are on the water.

Heat and Sun Safety

While many of us love the long hot summers here, they can be hazardous to children's health. Heat-related illness happens when the body’s temperature control system is overloaded. Infants and children up to 4 years of age are at greatest risk. Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather. For heat-related illness, the best defense is prevention.

  • Never leave infants, children, or pets in a parked car, even if the windows are cracked open.
  • Dress infants and children in loose, lightweight, light-colored clothing.
  • Schedule outdoor activities carefully, for morning and evening hours.
  • Stay cool with cool showers or baths.
  • Seek medical care immediate if your child has symptoms of heat-related illness.

Just a few serious sunburns can increase you and your child's risk of skin cancer later in life. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

  • Cover up. Clothing that covers your and your child's skin helps protect against UV rays.
  • Use sunscreen with at least SPF (sun protection factor) 15 and UVA (ultraviolet A) and UVB (ultraviolet B) protection every time you and your child go outside.

Enjoy our great outdoors but follow these tips to keep you and the family safe this summer!

For more information and tips visit http://www.cdc.gov/family/kids/summer/

Today Dakota Seabrook seems like your average teen-age high school student - playing video games, shooting hoops and acquiring an impressive collection of athletic shoes.  But Dakota's path to this role is anything but average. For most of his life, Dakota has suffered from the debilitating pain crises associated with Sickle Cell Disease (SCD).  In 2012 though, he participated in a clinical trial at MUSC for treatment of SCD that has changed his life.  This treatment consists of bone marrow transplant from unrelated donors and it has the potential to actually cure SCD.  Watch Dakota's inspiring story in this video. Dakota Seabrook  A Second Chance

MUSC Children’s After Hours Care has opened a new location in Summerville, located at 4330 Ladson Road, near Midland Parkway. The clinic offers a 100% pediatric staff to treat urgent care needs when your doctor's office may be closed. Care for newborns through age 17 is offered without an appointment from 4pm-10pm, Monday-Friday and 12pm-7pm Saturday, Sunday and holidays. The expansive hours and short wait times will appeal to parents who need the benefits of a pediatric setting, without the hectic and frightening pace and atmosphere of a medical center emergency room. All equipment - including a state-of-the-art digital X-ray system - is sized for children.

Offering treatment for:

  • Episodic illnesses including sore throats, earaches, bronchitis, cough, colds, flu and upset stomach
  • Sprains, strains and fracture care (sports-related injuries)
  • Asthma therapies - breathing treatments
  • Point of care testing - urinalysis, RSV, influenza, rapid strep
  • Urinary catheterization
  • IV therapy for dehydration
  • Splinting
  • Simple laceration repair with glue and/or steri-strips
  • Foreign body removal
  • Transfer of any patient who needs more specialty-based care or has an acute illness that requires more serious intervention

Summerville Family & Friends Day
Stop by our new Summerville After Hours location for Family & Friends Day on Saturday, May 24th from 9am-11am. Tour the facility, learn more about our services and meet our staff. Children may bring a stuffed animal or toy to be “examined” by the doctor.

MUSC Children’s After Hours Care Locations:

SUMMERVILLE
4330 Ladson Road
Summerville, SC 29485
843-876-8950

MT. PLEASANT
2705 Hwy 17 North, Suite 100
Mount Pleasant, SC 29466
843-876-2222

NORTH CHARLESTON
2750 Dantzler Drive, Unit 102
North Charleston, SC 29406
843-876-2220

Clinic Hours:
4pm-10 pm Monday- Friday
12pm-7pm Saturday, Sunday, holidays

MUSCkids.org/afterhours

 

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