NUEM - Jan 5, 2016 - Author: Stelter J // Edited by: McCloskey C
"When evaluating a patient that has potentially ingested a battery, the first and most important step is to evaluate their airway to make sure it is patent and that they have not aspirated the battery into the trachea. If the airway is stabilized and the patient is not displaying any signs or symptoms that would indicate immediate surgical or GI intervention, an X-ray should be performed to localize the battery. Ideally, in the pediatric population, this is a “baby-gram” or an x-ray from head to rump. If a battery is localized, such as in the X-ray shown previously, in the esophagus, the next step is an emergent GI consult to have the battery endoscopically removed and to have the GI tract and surrounding mucosa evaluated for tissue damage. If the patient is symptomatic, such as complaining of chest pain, difficulty swallowing, vomiting, abdominal pain, the battery needs to be emergently removed, regardless of where the battery is located.
Batteries, if located in the stomach, can be observed for passage if the patient is asymptomatic. The patient should be closely observed for battery passage and can be followed with serial x-rays to ensure passage. Any symptomatic patient needs immediate evaluation and potential surgical removal regardless of where the battery is located in the gastrointestinal tract. A treatment algorithm such as this can be used to guide evaluation and management:
