Jordan Kathleen S, Carpenter Cody, Steelman Sara H
Author Affiliations: Pediatric Emergency Department, Mid-Atlantic Emergency Medicine Associates, Charlotte, North Carolina (Drs Carpenter and Steelman) and UNC Charlotte School of Nursing, Charlotte, North Carolina (Dr Jordan).
Adv Emerg Nurs J. 2025;47(2):122-128. doi: 10.1097/TME.0000000000000565. Epub 2025 Apr 30.
Foreign body ingestion is a common complaint encountered in the emergency department among both adults and children. Children under the age of 6 years are at especially high risk of foreign body ingestion, including coins, toys, jewelry and batteries. The button battery is the most common battery ingested and has the highest potential for serious and fatal injuries in infants and children. Over the past decade there has been a dramatic increase in the incidence of button battery ingestions directly related to the widespread expansion and availability of common consumer electronics powered by button batteries. Most ingested foreign bodies pass through the gastrointestinal system spontaneously and without complications. However a button battery that becomes lodged in the nasopharynx, oropharynx, trachea, esophagus, or any part of the gastrointestinal tract is associated with an exceptionally high rate of complications, including death. Button batteries lodged in the esophagus are especially dangerous and require immediate removal as serious tissue damage may occur in as little as 2 hours. Emergency care providers must maintain a high index of suspicion and be fully aware of the dangers of button battery ingestion. Initial symptoms may be variable nonspecific symptoms including fussiness, decreased appetite or refusal to eat or drink, drooling, difficulty swallowing, hematemesis or abdominal pain. Obtaining plain radiographs for foreign body ingestion should not be delayed. In addition, emergency care providers can be advocates for the safety and protection of button battery ingestions through knowledge dissemination and public advocacy.
异物摄入是急诊科成人和儿童常见的就诊原因。6岁以下儿童异物摄入风险尤其高,摄入的异物包括硬币、玩具、珠宝和电池。纽扣电池是最常被摄入的电池类型,对婴幼儿造成严重和致命伤害的可能性最高。在过去十年中,纽扣电池摄入的发生率急剧上升,这与由纽扣电池供电的普通消费电子产品广泛普及和易于获取直接相关。大多数摄入的异物会自发通过胃肠道系统,且无并发症。然而,卡在鼻咽部、口咽部、气管、食管或胃肠道任何部位的纽扣电池会引发极高的并发症发生率,包括死亡。卡在食管的纽扣电池尤其危险,可能在短短2小时内就会造成严重组织损伤,因此需要立即取出。急救人员必须保持高度警惕,充分意识到纽扣电池摄入的危险性。初始症状可能是各种非特异性症状,包括烦躁、食欲减退或拒食、流口水、吞咽困难、呕血或腹痛。对于异物摄入,不应延迟进行X光平片检查。此外,急救人员可以通过知识传播和公众宣传,倡导对纽扣电池摄入的安全防护。