Caring for children who have suffered button battery ingestion

As the UK’s top paediatric doctors warn of the devastating impact of children swallowing button batteries, we meet some of the team from Great Ormond Street Hospital (GOSH) who care for the patients who have suffered from this ingestion injury.

Meet the team

 

Richard, Paediatric Ear, Nose & Throat (ENT) and airway surgeon on the Tracheal team 

“ENT teams, especially those at A&E departments across the country, are initially involved in identifying that a child has swallowed a battery rather than a coin or other small object. Once this has been done, we remove the batteries that have become stuck in the oesophagus as quickly as possible. At GOSH in particular, the ENT team in conjunction with the other specialist surgeons are involved in repairing the severe injuries caused to the airways after swallowing these batteries.”

Clare, Consultant Radiographer in the Interventional Radiology department

"My role is centred on performing diagnostic tests before surgery to identify the exact position and severity of the injury. I also manage the imaging and treatment that may be needed after surgery. For example, children’s airways can collapse after a button battery injury, causing breathing difficulties – so I may insert a stent to hold the airway open. I also treat patients whose oesophagus has narrowed, causing difficulty swallowing. To help, I inflate a balloon in the oesophagus to stretch the narrow section. Once patients who have swallowed batteries are admitted to GOSH, I see them regularly – I’ve seen some children every four weeks for two years!"

Nagarajan, Consultant Cardiothoracic Surgeon

"I operate on children who have injuries to the trachea – firstly to save their life, and then to try and repair their trachea. I work closely with many teams to look after these children, including radiologists – who carry out imaging of the airways which helps me to plan the surgery. I also work with the Paediatric Intensive Care team in order to stabilise these children before getting them to surgery. During surgery, we use the membrane from around the heart to create a pericardial patch, which acts as a covering to repair holes made by the battery. We then check the repair site in the operating room using a bronchoscopy, to ensure the repair is complete. I continue to see these children after surgery on a regular basis, as they often require follow-up procedures."

Caroline, Clinical Nurse Specialist (CNS) with the General Surgical team

"I work closely with the doctors and other CNSs to provide ongoing support to families throughout their time at GOSH. The impact of this type of injury can be far reaching and I help families deal with the impact that a life-changing injury can have on them as a whole. I co-ordinate parents learning how to tube feed their children if they can’t eat anymore, as well as arranging hospital appointments, bed space, and travel for those coming long distances. I also liaise with social workers and psychologists to ensure all the family’s needs are being met."

Joe, Consultant Neonatal and Paediatric Surgeon

"Sometimes, the damage caused by swallowing a battery is so severe that it can’t be repaired, which may mean I’m involved in performing surgery to remove the severely damaged oesophogous and replace it with the stomach. The procedure enables children to eat and drink safely by mouth, something they are unable to do with a damaged oesophogous. The surgery is carried out by keyhole and takes five to eight hours. They would then come back for regular outpatient appointments to check that healing is complete and their growth and development are proceeding normally."

Clare, Clinical Psychologist with the General Surgical team

"We know that being in hospital can be a very stressful and worrying time for children and their families. When a child sustains this type of injury, families are often dealing with a variety of feelings, including shock, guilt and anger. Parents, in particular, tend to blame themselves even though the injury was the result of an accident. The children involved are often very young, so my role is focused on helping parents to cope the best they can, and to effectively support their child throughout their hospital stay and treatment."

Read about patient Valeria, who continues to receive specialist treatment after swallowing a watch battery.