Buffalo Center Ambulance

10/28/2025

Worth the read if you are ever around any kids!!

🚨 When the Call Comes In

You ever get that gut-drop call from dispatch- “possible battery ingestion”? Yeah, that one. You can feel your pulse climb before you even turn the key. Because here’s the truth: those shiny little lithium coin cells aren’t choking hazards. They’re chemical grenades once they hit moisture.

I’ve seen a toddler who looked fine. Laughing even and by the time we got x-rays, the esophagus was basically a charred crater. You don’t forget that kind of thing.

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⚡ What’s Actually Going On Inside

Lithium coin batteries pack 3 volts, compared to the old 1.5-volt alkaline or silver oxide cells. That extra juice turns saliva into a science experiment from hell. The second that battery gets stuck in the esophagus, current starts flowing. Electrolysis kicks in, the negative pole spits out hydroxide ions, and the tissue pH skyrockets above 12. That’s like dunking the esophagus in drain cleaner.

Within 15 minutes, the burn starts. By two hours, you’re looking at deep necrosis, holes, perforation, and surgical emergencies nobody wants. The scary part? The kid might look totally fine.

Even after removal, the chemical reaction keeps cooking. Reperfusion injury adds fuel to the fire, and days later you can see tracheoesophageal fistulas, vocal cord paralysis, or even a fatal aortoesophageal fistula.

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🔋 Why Lithium Is So Much Worse

Lithium = more voltage = more current = more tissue destruction. They’re smaller too, so they wedge perfectly in a child’s esophagus. And unlike older batteries, they don’t just leak acid; they generate it on contact.

Alkaline cells might irritate. Lithium ones cook.

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💧 The Water Myth: Will It Explode?

Nope. Button batteries don’t explode in the body. They’re not like v**e pen or laptop lithium-ion packs that fail thermally. These little ones burn chemically.

But here’s the catch: do not give water, milk, or food; keep NPO per guideline. Honey is the only endorsed interim agent for ≥12 months.

If the child’s over 12 months old, alert, and swallowing safely, give 10 mL of honey every 10 minutes, up to six doses, while you’re hauling tail to the ED. Honey coats the battery, reduces current flow, and slows the burn. That’s straight from the National Capital Poison Center.

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🚑 Field Game Plan for EMS and Nurses
1. Suspect early. Unexplained drooling, vomiting, chest pain, or refusal to eat in a toddler? Think battery until proven otherwise.
2. Keep NPO. No food, no drinks, no antacids.
3. Honey protocol: 10 mL every 10 minutes up to six doses (≥12 months, alert, able to swallow).
4. Transport immediately. Time is tissue.
5. Call Poison Control: 1-800-222-1222 — they’ll update and coordinate.
6. Document ingestion time and battery type if known.

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🏥 What Happens in the ED (And Why You Should Know)

The ED team will grab AP and lateral neck/chest x-rays to find that tell-tale “double-ring” sign.
If it’s stuck in the esophagus, endoscopic removal within 2 hours; no arguments.

They might use sucralfate suspension (1 g/10 mL, 10 mL every 10 minutes × 3 doses) while prepping.
Some centers irrigate post-removal or apply weak acid solutions to neutralize residual burn, but that’s specialist work.

If the battery’s already in the stomach, they’ll monitor, especially in kids under six or if the battery’s ≥20 mm. Watch for delayed complications like bleeding, cough, or voice change.
Full guidelines are detailed in ESPGHAN’s 2021 position statement.

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💡 Field Pearls to Live By
• A smiling toddler can still have a dying esophagus. Don’t get comfortable.
• Always check if there’s a second battery missing.
• Magnets + batteries = surgical nightmare.
• Even after removal, delayed fistulas can appear days later.
• Always educate caregivers: watch for bloody emesis, persistent cough, or hoarseness.

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🧠 Takeaway

Lithium button batteries aren’t harmless power cells. They’re 3-volt alkali generators with one mission—burn through tissue.

If you suspect it, move fast.
Honey buys you minutes, transport buys survival, and teamwork seals the deal.

And the kid? He’ll probably be giggling while you’re sweating bullets, calling ahead, and praying radiology’s ready.
That’s this job—equal parts chaos and chemistry.

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📚 References (Evidence-Based Sources)
1. National Capital Poison Center. Button Battery Ingestion Triage and Treatment Guidelines. Revised 2023. www.poison.org/battery
2. Anfang RR, Jatana KR, Linn RL et al. pH-neutralization of esophageal tissue injury after button battery ingestion. Laryngoscope. 2019; 129(1): 49–57.
3. Jatana KR et al. Pediatric button battery injuries: 2013 Task Force Update. Int J Pediatr Otorhinolaryngol. 2013; 77(9): 1392–1399.
4. Litovitz T et al. Preventing battery ingestions: analysis of 8648 cases. Pediatrics. 2010; 125(6): 1178–1183.
5. National Battery Ingestion Hotline. Clinical Management of Button Battery Ingestion. Updated 2024. 1-800-498-8666
6. Emergency Nurses Association. Clinical Practice Guideline: Foreign Body Ingestion in Children. Updated 2023.
7. NIH / NCBI. Button battery ingestion: Hazard of the decade. Front Pediatr. 2022; 10: 874312.
8. ESPGHAN Position Paper: Diagnosis, Management, and Prevention of Button Battery Ingestion. 2021.

10/28/2025

To all of our people who balance the title and life, we thank you sincerely.

Today is National First Responders Day.

A huge THANK YOU to every police officer, firefighter, 911 Dispatcher, EMT and every single first responder serving their communities.

We see your sacrifice and we appreciate you today and always!

10/28/2025

Similar to puffy coats, Halloween costumes with excess material can prevent a car seat from keeping your child SAFE in a crash. 💢🚗

Don't risk it — change them into their costumes at your destination. 🦄✔️

10/14/2025

Costumes ready ✔️
Treats on the Street - Main Street Sunday October 26th 3pm-4:30pm.
Come visit our circus! 😊

10/01/2025

It is better to know what to do if emergencies happen. Know CPR and be aware!

09/24/2025

09/16/2025

We want everyone safe this harvest season. We are all trying to get to one place at a time in one piece. 🛻 🚜