Disc battery ingestion - Queensland Ambulance Service
Clinical Practice Guidelines:
Other/Disk battery ingestion
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Date
October, 2015
Purpose
To ensure a consistent approach to the management of a patient with
Disc battery ingestion.
Scope
Applies to all QAS clinical staff.
Author
Clinical Quality & Patient Safety Unit, QAS
Review date
October, 2017
URL
https://ambulance.qld.gov.au/clinical.html
This work is licensed under the Creative Commons
Attribution-NonCommercial-NoDerivatives 4.0
International License. To view a copy of this license,
visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Disc battery ingestion
October, 2015
Disc batteries are small, coin shaped, single cell batteries most
commonly used in residential households to power small electrical
devices (e.g. hearing aids, watches, children’s toys and musical
greeting cards).
Clinical features (cont.)
UNCONTROLLED WHEN PRINTED
High risk features for airway compromise:
Choking or gagging (sometimes overheard rather then directly observed)
All suspected disc battery ingestions should be considered a medical emergency. Mucosal trauma will commence in as little as 2 hours and if untreated, may lead life-threatening gastrointestinal
bleeding or death secondary to major vascular injury. [1,2,3]
•
•
•
•
•
•
hoarse voice
dyspnoea
stridor
drooling
painful swallowing
vomiting
UNCONTROLLED WHEN PRINTED
Despite assurances from the parents that no disc batteries were
available and/or the child’s denial of disc battery ingestion, it is
essential that paramedics consider disc battery ingestion as a
differential diagnosis in any child presenting with choking,
hematemesis, discoloured or bloody/black stools.
Common symptoms in cases of delayed disc
battery ingestion: [1,2]
• chest pain
• abdominal pain
• unexplained gastrointestinal bleeding
(melena)
• bloody/black stools
• regurgitation or drooling
• vomiting without fever or diarrhoea
• haemoptysis
• hematemesis
• prolonged food refusal/ inability to swallow solids
UNCONTROLLED WHEN PRINTED
Clinical features
High risk features for airway compromise:
Choking or gagging (sometimes overheard rather then directly observed)
•
•
•
•
•
•
hoarse voice
dyspnoea
stridor
drooling
painful swallowing
vomiting
UNCONTROLLED WHEN PRINTED
Figure 2.101
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Risk assessment
CPG: Paramedic Safety
CPG: Standard Cares
• Any disc battery with residual voltage can cause significant tissue damage.
UNCONTROLLED WHEN PRINTED
• 12% of children who ingested a 20 mm disc battery suffered severe or fatal injuries[3]
• Peak age for disc battery related injury is 1-5-years; younger cases having been
reported in literature (possibly fed batteries by siblings)[1]
Parent/Child reported history of:
• disc battery exposure
• choking
• haemoptysis/hematemesis
Note: Officers are only to
perform procedures for which they have received
specific training and authorisation by the QAS.
UNCONTROLLED WHEN PRINTED
• Signs and symptoms are non-specific; history provided at the patient’s residence may alert officers to the possibility of disc battery ingestion
• Denial of disc battery ingestion in a child of any age cannot exclude it[1]
Attempt to identify type of battery,take product packaging to hospital if possible
• Nil by mouth
UNCONTROLLED WHEN PRINTED
• Most fatal/ severe cases are associated with occult ingestion of a battery (caregivers are often unaware that the battery is missing/has been ingested). In these situations, there may be no history suggesting battery related injury.
Consider:
•
•
•
•
IV access
Analgesia
Antiemetic
IV fluid
UNCONTROLLED WHEN PRINTED
• Transport suspected disc battery ingestion cases to facility that has capacity for x-ray.
Transport to hospital
Pre-notify as appropriate
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