If a child swallows a button battery or at least two strong magnetic beads, go immediately to an emergency department with gastroscopy available; do not wait for them to pass or induce vomiting

The preventive steps cost nothing; emergency X-rays and removal are separate expenses. Secure the battery compartments of remote controls, electronic scales, and car keys. Keep spare batteries and magnetic beads out of children's reach. The difficulty is that ingestion is often unwitnessed and the child may initially have no symptoms.

US poison database figures for 1985–2009 showed a 6.7-fold rise in the proportion of button battery ingestions resulting in major injury or death. Lithium batteries 20 millimeters in diameter were the most dangerous. Outcomes were significantly worse in children younger than 4 and with lithium batteries at least 20 millimeters in diameter. A battery lodged in the esophagus can cause severe, lasting injury within 2–2.5 hours. In 92% of fatal cases and 56% of major injury cases, nobody had witnessed the ingestion. At least 54% of fatal cases and 27% of major injury cases were initially misdiagnosed because symptoms were atypical. Damage can continue to progress after removal. Esophageal perforation, fistulas between the esophagus and trachea or major blood vessels, and massive bleeding have appeared days later. Another analysis of 8648 cases found that 61.8% of batteries swallowed by children younger than 6 had been taken directly from an appliance. The US National Capital Poison Center's guidance says not to induce vomiting after suspected battery ingestion. A battery in the esophagus can cause serious burns in as little as 2 hours, so do not wait for symptoms. Children younger than 12 need immediate X-rays to locate the battery. Guangdong CDC's product injury surveillance recorded nearly 100 battery-ingestion injuries over the past five years, mostly involving button batteries. Children aged 0–6 accounted for 92.9% of injuries. Moderate or severe injuries accounted for 39.3%, and 25.0% required hospitalization. Its advice is to seek medical care immediately and not attempt to induce vomiting or feed the child. The same surveillance report says swallowed Buckyballs, or magnetic beads, can attract each other across adjacent bowel loops, compressing the bowel and causing obstruction or perforation. Suspected ingestion requires immediate medical care. A 2025 literature review included 130 children who developed fistulas between bowel segments after swallowing at least 2 magnets. Median age was 3.3 years; 95.5% required surgery, 19% developed postoperative complications, and 1 child died.

Litovitz T 等 (2010). Emerging battery-ingestion hazard: clinical implications. Pediatrics 125(6):1168-1177. https://doi.org/10.1542/peds.2009-3037；Litovitz T, Whitaker N, Clark L (2010). Preventing battery ingestions: an analysis of 8648 cases. Pediatrics 125(6):1178-1183. https://doi.org/10.1542/peds.2009-3038；National Capital Poison Center. National Battery Ingestion Hotline Guideline：「If battery ingestion is suspected: Do not induce vomiting」「Batteries lodged in the esophagus may cause serious burns in as little as 2 hours. Do not wait for symptoms to develop」. https://www.poison.org/battery/guideline；广东省疾病预防控制中心 (2025). 监测发现：这3种小物件易被孩子误吞，很多人家里都有，赶紧放好！. https://cdcp.gd.gov.cn/jkjy/jkzt/zlkz/content/post_4686546.html；Kelaidi N 等 (2025). Entero-Enteric Fistula Following Multiple Magnet Ingestion in Children: A Systematic Review. Journal of Clinical Medicine 14(17):6235. https://doi.org/10.3390/jcm14176235；Nugud AA 等 (2023). Pediatric Magnet Ingestion, Diagnosis, Management, and Prevention: A European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Position Paper. Journal of Pediatric Gastroenterology and Nutrition 76(4):523-532. https://doi.org/10.1097/MPG.0000000000003702；Anfang RR 等 (2019). pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope 129(1):49-57. https://doi.org/10.1002/lary.27312；Schmidt YM, Muensterer O, Wendling-Keim D (2023). The use of honey in button battery ingestions: a systematic review. Frontiers in Pediatrics 11:1259780. https://doi.org/10.3389/fped.2023.1259780

The evidence grade is B because the figures come from poison hotlines and case registries, without a controlled comparison showing how many deaths this response prevents. The benefit is judged large: an esophageal battery can cause severe injury within 2 hours, and many deaths followed unwitnessed ingestion and diagnostic delays. The beneficiaries are almost always your own children. Bring a battery of the same type, its packaging, or the appliance so the doctor can identify it. Chinese and US advice differs on giving honey during the journey. The US National Capital Poison Center permits it if the child is at least 1 year old, ingestion was less than 12 hours ago, the child can swallow, and honey is immediately available: 10 milliliters every 10 minutes, up to 6 doses. This is based on experiments in live pigs; a 2023 review said human evidence remained very limited. Guangdong CDC advises giving no food. Never give honey to a child younger than 1. Honey can only slow the burn; it cannot replace removal, and searching for honey must not delay departure. If a battery and magnet were swallowed together, the US center requires removal even after the battery reaches the stomach. Older people swallow batteries too: in the 8648 cases, 15.5% involved mistaking a battery for a pill, mainly among older people. Hearing-aid batteries accounted for 36.3% of all ingestions. If an object is blocking breathing, first follow Item 26 in this section (back blows and abdominal thrusts for choking) or Item 43 (infant choking). For swallowed cleaning products or medicines, see Item 20 (accidental ingestion of cleaning products).