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Button batteries in the ear, nose and throat: a novel survey of knowledge of UK advanced nurse practitioners

23 June 2022
14 min read
Volume 31 · Issue 12



Button battery (BB) impaction in the ear, nose and throat can result in significant morbidity. Advanced nurse practitioners (ANPs) are increasingly responsible for initial patient assessment and prompt escalation to otolaryngologists for definitive management.


Our novel national study aimed to assess ANPs' knowledge with respect to the assessment and management of patients with BBs in the ear, nose and throat.


A national 13-point survey was disseminated among ANPs over a 2-week period. Knowledge was assessed through eight multiple choice questions with a maximum attainable score of 21.


A total of 242 responses were analysed. Knowledge deficits were identified in all domains (mean overall score 8.5/21), including presenting clinical features, preliminary investigations and intervention strategies. The overwhelming majority of respondents (97%; n=234) advocated for further training.


A need for further education has been highlighted by this surveyed cohort of ANPs. Implementation of standardised protocols, virtual resources and simulation platforms may address knowledge deficits.

Foreign body impaction is a common emergency presentation, particularly among the paediatric population (McConnell, 2013; Kodituwakku et al, 2017). In most cases, ingested foreign bodies traverse spontaneously through the gastrointestinal tract without sequelae (Rodríguez et al, 2012). However, impaction in the upper aerodigestive tract or aural cavity has the potential to cause significant morbidity (Rodríguez et al, 2012).

Button batteries (BBs) are among the most hazardous of foreign bodies and may cause severe harm within 2 hours of placement in the ear, nose or throat (ENT)(NHS England, 2014). A rising incidence has been observed because of an increase in household electronic devices and toys using these batteries (Kodituwakku et al, 2017). According to data collected by the National Capital Poison Center (2021) in the US, the incidence of BB ingestion has risen sharply over the past two decades, with 3467 cases reported in 2019; the exact incidence of BB ingestion in the UK is unknown (Healthcare Safety Investigation Branch, 2019).

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