Lithium Batteries Pose Deadly Threat to Kids

They’re common in everyday objects all around us, in gadgets like remote controls, watches, calculators, thermometers, toys and greeting cards. Nickel sized lithium batteries, or button batteries are often accidentally ingested by young children and they can be deadly.

Reports of children ingesting these “button batteries” have increased. More than 35,000 button battery cases are reported to poison control centers annually and 13 have been identified as the cause of death.

Within as little as two hours, after the round 20-25mm battery enters the body, it can cause severe tissue damage and other serious complications.

When a lithium battery becomes lodged in the body, it gives off an electrical current. Once the electric charge is set off, it reacts with the surrounding skin producing a strong acid similar to that found in home drain opener.

“It can cause a hole from the esophagus into the trachea or even into important blood vessels like the aorta. And in children where this is happening, they can lose a lot of blood and potentially, die,” said Dr. Lois Lee, an emergency room physician at the Children’s Hospital inBoston.

More that 80 kids have permanent damage from ingesting  button batteries. The chemical reaction triggered by the batteries can damage vocal cords leaving children with life-long whisper. Damage to the intestinal tract means some children require feeding tubes and even multiple surgeries.

TheAmericanAcademyof Pediatrics Committee on Injury says the problem is growing.

Parents are urged to be mindful this holiday season when purchasing electronics.

Emergency physicians suggest parents be on the lookout for the batteries and get down on the floor at their child’s level and look around to make sure they aren’t lying around the house.

Several of you have received letters from the VT Department of Health regarding your child’s immunizations. This has led to questions from parents as to how the Department of Health gets this information.

Vermont is one of the states that has an Immunization Registry. As a health care provider we are required to report to the Department of Health all data regarding required immunizations of children under the age of 18. This information is downloaded directly from our electronic medical records and sent through secure means to the registry.

Using read only access to the registry, school nurses are able to check the immunization status of students without troubling you and our office to provide this information. Emergency rooms can check the tetanus status of an injured patient. When a child transfers to us from another office we can search the registry for immunization records if you are having trouble getting records forwarded to us. Unfortunately not all offices have computer systems or manpower to enter the information so there are currently some children who’s immunizations are not entered.

After Katrina the administrator of the registry was able to access the Louisiana State registry and obtain records for children who had moved up here.

We hope that this information is helpful. If you have any further questions, please don’t hesitate to ask.

DEET containing repellents are considered to be among the best for biting insects. It may however be toxic if applied too often or ingested. It is not safe for infants six months or younger. It can be sprayed on clothing and camping gear, however, it may damage synthetics. DEET content of no more than 30% should be used on children over 6 months. Using a combination DEET/Sunscreen is not advised as the sunscreen needs to be applied more frequently and DEET may decrease the effective sun protection factor (SPF).

Permethrin is both a repellent and insecticide, making it the repellent of choice to prevent tick bites. It is meant to be applied to clothing and camping gear – not to the skin.

Picardin is a new agent, popular in Europe, that is more effective against mosquitoes and less toxic to humans. It is odorless, leaves no residue and lasts 8-10 hours. Manufacturer’s warning suggests that it not be used on children under 2 years.

Citronella oil and lemon eucalyptus oil are less effective. Citronella gives 20-30 minutes of protection and lemon eucalyptus oil may last 2-5 hours.

First Aid

Your child’s reaction to a bite will depend on his or her sensitivity to that insect’s venom. If bites are itchy, applying a cool compress or calamine lotion can help. Depending on the child’s age and level of discomfort, an oral antihistamine may be used – ask your pediatrician.  Watch for signs of infection (the bite becomes larger, redder, more swollen and painful, yellowish fluid or a fever). Try to keep you child’s nails short and minimize scratching. See your pediatrician if you see signs of infection.

Stings can be quite painful. Removing the stinger as soon as possible helps decrease the amount of venom entering the skin. If the stinger is visible, try scraping it horizontally to remove it.  Squeezing the stinger may cause a release of more venom.

Daily tick checks are a must and do not take to long. Check your child from head to toe, including scalp, under arms and in skin folds. The transmission of Lyme disease does not happen until the tick has started to feed, usually after it has been attached 48-72 hours or longer. thus doing a daily check will diminish the risk of getting Lyme disease.

Remove the tick with tweezers grasping it as close to the head as possible. Pull back to avoid breaking it and leaving the head of the tick imbedded. Sometimes there is a localized reaction. Watch for signs of infection. Monitor child for next 30 days, watching for a localized rash at the site that is circular or oval and expands with time, fever, malaise or  joint pains/swelling. Call us if your see any of these signs.

After six months of age, a child can use hypoallergenic sunscreens (Aveeno and Neutrogena have products in this category).

• Remember water reflects light so there is risk to tender skin even in the shade. Seeking the shade when with children is critical during the peak sunshine hours of the day, between 10am and 2pm.
• The nose, lips, back of neck, upper back and back of knees are sites where significant burns are noted in childhood.
• Select sunscreen with an SPF of 30 or higher and with UVA-screening ingredients.

Regardless of any “-proof” or “-resistance claims. All patients should adhere to these sun-screen use and application guidelines:

• It takes about 2 ounces of sunscreen to adequately cover all sun exposed areas of the body – excluding the face, ears, and scalp –of an average adult. Parents may estimate a sufficient amount of sunscreen based on the child’s size relative to an adult.  Over-application is preferable to insufficient application.
• Individuals should apply sunscreen to all sun-exposed skin 15-30 minutes prior to sun exposure.
• Individuals should re-apply sunscreen at least every two hours, regardless of product claims.
• Excessive sweating, swimming, and/or toweling off of the skin warrants immediate reapplication of sunscreen regardless of elapsed time or product claims.

The office will be open for urgent care only until noon on Memorial Day, Labor Day, Christmas Eve Day and Jan 1, 2013.

Go to http://www.npr.org/blogs/money/2011/12/05/142634542/why-burn-doctors-hate-instant-soup

Poison Control tips for children - includes a video

 Clinics at TLP 2011

We have all injectable doses of flu vaccine available at both offices.