Triage and treatment guideline for button-battery ingestions. AP indicates anteroposterior; NPO, nil per os. a NPO. Anesthesia may be required for removal. b Radiograph abdomen, esophagus, and neck. Batteries above the range of the radiograph have been missed. If battery is in esophagus, obtain anteroposterior and lateral views to determine orientation of negative pole. If ingestion is suspected and no battery is visualized on radiographs, check ears and nose. c If battery diameter is unknown, estimate it from the radiograph, factoring out magnification (which tends to overestimate diameter).
NBIH data (July 1990–September 2008 only). Lithium cells were more likely associated with clinically significant outcomes compared with each other button cell chemistry (logistic regression, P < .001 versus zinc-air [OR: 65.2], silver oxide [OR: 22.5], manganese dioxide [OR: 13.1], and mercuric oxide [OR: 6.5]).