Get the (button) cell out

Apart from people who got the wrong idea from last week‘s Featured Article and want a power source for laser-powered eyes (which means they weren’t paying attention), swallowing a button-cell battery is often dangerous, likely fatal, and a not-uncommon concern for parents of small children. Yes, we can snark off with comments on how kids love eating things that are not good for them and hate eating things that are good for them (and we adults do that too, don’t act high-and-mighty on your third slice of pizza), but let’s let that slide for now. After all, this is first aid.

Wikimedia Commons/Public Domain (Author: Pearson Scott Foresman, 2007)

Like other dry-cell batteries (not rechargeable, not the type you use to start cars), button cells work from electrochemical reactions between metals, helped along by a paste, labeled as ‘7’ in the picture above. The issue, as you might have gathered from reading some of the links from the beginning of this post, comes from the paste that I just mentioned: it’s quite corrosive. That smell from a leaking battery, that tingle you feel when you accidentally touch it, the fact that it’s eaten a little of the plastic or metal that surrounds it or even nearby electronic components – there’s your corrosion for you. Now think about what that could do to an esophagus, which is lined only with mucous membranes. According to the authors of this week’s Featured Article (which is not Open Access, sorry), serious injury can happen in as little as 2 hours as the battery case fails due to something not unlike a short circuit. But what can we do before the paramedics arrive, if there’s anything we can do to help? This week, Anfang et al. propose reducing the damage caused by the battery using an antiulcer treatment, Carafate®. If that’s not available, there are surely things around the house for that…?

Flickr/Public Domain (Author: The Residences at Mandarin Oriental, 2014)

The authors were not about to try this out on actual human children, so they used esophagi (plural for ‘esophagus’, and yes I’m using American spellings – I’m posting from the USA) from pig cadavers that were laid out on an incline and washed through with various fluids – Carafate, Gatorade®, various juices, honey, and maple syrup – every 15 minutes for 2 hours, when the battery fails and the pH was measured. The most promising ones from that in vitro test were then tested in vivo on anesthesized piglets and then looked what kind of damage occurred. Science isn’t always pretty unless you have a massive SFX budget – I hope it’s not put you off your breakfast.

Anyway, the authors wanted to see how well it neutralized the damage caused by the battery paste, which is alkaline (I’m not entirely sure at the moment why people always call it battery acid – I’m guessing because that’s what’s inside a car battery) in nature. Sure, one might think that ‘if it’s alkaline/basic, just neutralize with something slightly acidic,’ right? The juices, Gatorade, even coffee would work then. Turns out they don’t really do a good job of reducing the pH, meaning that the esophagus was still very much alkaline. So who’s the winner?

Public Domain (Author: Lemgo/D, 2014)

Wouldn’t you know it, it’s honey, our go-to treatment for a sore, scratchy throat did a really good job at keeping pH from going haywire and doing damage to the esophageal lining. They tested various kinds of honey: raw, organic, unfiltered, clover, you name it, they performed equally admirably – even better than Carafate! Although it should be noted that Carafate was not designed for preventing injuries caused by swallowing a button-cell, so let’s not be so quick to dismiss it as a medication for what it was designed for.

A few images from the article (can’t post them here – remember, it’s not Open Access) showed something interesting – the batteries that were lodged in the test esophagi were largely intact for honey and Carafate, while the batteries that were washed in saline while in the esophagus had pretty much corroded through, meaning that they did short out. There were still visible ulcers from where the battery made contact with the esophageal lining, even in honey, but it was much less noticeable than the ulcer left behind by the battery in saline solution, which looked like someone put the Darksign on the esophagus. Kind of morbid that I would use a reference from a game that featured undead, but it’s my blog.

Internet (Author Unknown)

You may have suspected that it may have something to do with the way honey – which is actually mildly acidic – coats your throat, providing a soothing treatment for nasty coughs and overall irritation. The authors propose that honey may not only coat the esophageal lining, but may actually be coating the battery as well (probably why it wasn’t damaged and leaking). Thus, the authors recommend that as soon as one notices that the victim (especially a small child) has swallowed a button-cell battery, have them swallow some honey, reasonably 2 teaspoons every 10 minutes, until the paramedics get there. You could still use Carafate should you have some at home, especially since it seems to create a similar coating that protects the esophagus and does a good job of keeping the battery from corroding and leaking, but (in my opinion, anyway) you are more likely to have honey at home. Unless of course, you’re the type to put Carafate on your biscuits, then in that case you probably did swallow a button cell so you could get laser eyes from last week’s blog, therefore shouldn’t be having children anyway.

Thoughts? Comments? Thought that this was a helpful bit of first aid? Got recipes for a gentle lemon-ginger tea? Let me know in the space below, throw a like if you liked it, and you don’t need to be a WordPress member to do it! If you’re not doing so already, please follow (if you’re into scientific research with snarky commentary from an overly-caffeinated blogger-scientist) and thanks again for stopping by.

Featured Article: Anfang RR, Jatana KR, Linn MD, Rhoads K, Fry J, Jacobs IN. (2019). pH-Neutralizing Esophageal Irrigations as a Novel Mitigation for Button Battery Injury. The Laryngoscope. DOI: 10.1002/lary.27312.

Featured Image: Wikimedia Common/Public Domain (Author: Ubcule, 2009)

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