Today the Healthcare Safety Investigation Branch (HSIB) publishes its independent investigation into the death of a three-year-old who swallowed a button battery.

Its report makes recommendations in three key areas – public awareness, product safety and clinical decision-making.

The Child Accident Prevention Trust are working closely with HSIB, government and industry to make the recommendations a reality and prevent any more of these devastating deaths to children.

What’s the problem?

When a button battery, particularly a powerful 3V lithium coin cell battery, gets stuck in a small child’s food pipe, it can burn a hole inside the body and cause serious internal bleeding and death.That’s because the battery creates a chemical reaction that erodes soft tissue. If it burns through the main artery, a child can haemorrhage to death. The reaction can happen in as little as two hours. Symptoms are often not obvious until it’s too late.

Children between 1 and 4 are at greatest risk as they often put things they find in their mouths. And they can find lithium coin cell batteries in so many places – in products and gadgets, in cheap toys and novelty items, and in multi-packs of spares.

In fact, even discarded ‘flat’ batteries still hold enough power to badly hurt a child.

Unfortunately, as HSIB’s report identifies, too few parents know about the dangers they pose or how to manage the risks. We’re on a mission to change that.

Public awareness

We are working in collaboration with the Office for Product Safety and Standards (OPSS) and the British and Irish Portable Battery Association (BIPBA) on a national safety campaign launching today. Look out for posts on Twitter and Facebook.

Through our continuing partnership with BIPBA, we recently launched a downloadable session plan to help staff raise awareness with parents in an engaging way.

Today we’re launching a new downloadable poster Button batteries: Where are yours?. We’re encouraging parents to know where lithium coin cell batteries are in their homes – in products as well as spare and ‘flat’ batteries – so they can keep them out of children’s reach and keep children safe.

We have also updated our safety advice and our safety flyer using insights from HSIB’s report.

Please share these resources as widely as possible with friends, family and colleagues. We need your help to spread the word to parents with small children so we can prevent future tragedies.

Product safety

HSIB’s investigation identified that while there are safety regulations for children’s toys, so lithium coin cell batteries are secured in battery compartments and can’t be accessed by small children, there are no equivalent safety regulations for other products in our homes.

They also found that, while reputable manufacturers use child-resistant packaging, there is no requirement to do so. Nor is there a requirement to place a warning on the packaging highlighting the serious consequences for a small child of swallowing a lithium coin cell battery.

As a result, the Office for Product Safety and Standards has commissioned BSI to develop a fast-track safety standard (called a PAS) looking at battery design, product casing, packaging and safe retailing.

We will be part of the advisory group for the fast-track standard and look forward to working with industry, government and product safety experts on this project.

Support for clinical decision-making

Unfortunately there are few obvious symptoms that a coin cell battery is stuck in a child’s food pipe. And small children can’t always tell adults what has happened. This makes it a real challenge for busy staff to diagnose the problem.

As a result of HSIB’s investigation, NHS call handlers now have a specific prompt on button batteries, when they are asking questions about a child swallowing something harmful.

There is a recommendation for the Royal College of Paediatrics and Child Health to develop a tool to support clinical decision-making, with support from the Royal College of Emergency Medicine.

HSIB also suggests that a study should be conducted in emergency departments evaluating the use of handheld metal detectors to scan under-fives who present with non-specific symptoms.

Looking ahead

CAPT have been working on button battery safety for the last five years. Since 2017, we have been working in partnership with BIPBA to help parents understand the dangers that powerful lithium coin cell batteries can pose to small children and how best to manage the risks.

We are delighted that HSIB’s independent investigation is finally giving the issue the profile it deserves, and that the circle of collaboration is growing by the day. Please join us in helping to spread the word and preventing these devastating deaths.