SHORT ANSWER
Advances and Answers in Pediatric Health
Hot Button Issue
GASTROENTEROLOGY & RADIOLOGY
According to the National Safety Council , roughly 3,500 people swallow button batteries in the U . S . each year . Once they become lodged in the body , they can cause serious damage , such as vocal cord paralysis , mediastinitis and aortoesophageal fistula , which is typically fatal .
Using radiography to determine button battery location ahead of removal has long been common practice , but this approach falls short in its ability to detect the level of injury inflicted . Since 2012 , Children ’ s Hospital Colorado has remedied that shortcoming by employing MRIs after battery removal to provide more information and reduce complications . A recently published retrospective study ( 1 ) conducted by Children ’ s Hospital Colorado researchers uses data from the six-year period between 2012 and 2018 to understand the lessons of that practice and share them with the broader medical community .
The study found that using MRIs to determine severity , location and evolution of soft-tissue injury was critical in guiding clinical decisions and in helping Children ’ s Colorado ’ s medical team understand key patterns in button battery injury . For example , researchers found that the most severe complications occurred when the battery lodged in the cervical esophagus . What ’ s more , MRIs played an important role in determining safe patient discharge .
“ Providers who care for these children after battery removal are left to decide how long they stay in the hospital and when it might be safe for them to begin eating , knowing that they continue to face a risk of fatal aortoesophageal fistula for up to several weeks ,” explains Robert Kramer , MD . “ Use of these noninvasive imaging tools helps to better define that risk , as well as monitor improvement over time to better inform these decisions .”
According to Dr . Kramer , this research can make an impact beyond Children ’ s Colorado . He hopes to see the results of this study lead to standardized care for button battery ingestion across institutions , with the goal of decreasing both morbidity and mortality risks .
1 . Grey , Neil E O et al . “ Magnetic resonance imaging findings following button battery ingestion .” Pediatric radiology vol . 51,10 ( 2021 ): 1856-1866 .
Gaming the System
CHILD LIFE
In September 2021 , Children ’ s Colorado partnered with Child ’ s Play Charity to host a conference exploring virtual reality , extended reality and gaming in a medical setting . The Pediatric Gaming Technology Symposium was the first gathering of its kind in this emerging field .
The two-day virtual conference drew a global audience of professionals and included discussions of gaming specialties at other hospitals , 3D printing , physical therapy interventions and more . It opened with a keynote address by Jane McGonigal , a video game designer whose therapeutic games have made significant waves . She created a game called SuperBetter , which gamifies various therapies , and shared the many benefits of using this technology in the pediatric space . In addition to attending a wide variety of discussions , participants benefited from a virtual social space which allowed them to interact via avatars and continue the conversation outside formal sessions .
Attendees also met with various other experts , including Abraham Homer , Children ’ s Colorado ’ s gaming technology specialist , who presented about using virtual and augmented reality for pediatrics .
When Children ’ s Colorado brought Homer into its community back in 2019 , it became the first pediatric hospital to fill such a role . Under Homer ’ s lead , Children ’ s Colorado has found new applications for gaming , such as virtual reality for procedures like lumbar punctures in lieu of anesthesia and augmented reality in the burn clinic . More projects are underway to grow the program in house , but Homer says he also hopes to help centralize gaming knowledge and build a strong foundation for the future beyond Children ’ s Colorado . The symposium helped move this goal forward .
“ In healthcare everything is very formalized , but for gaming techs it ’ s just so unprecedented that there ’ s not really a good roadmap ,” Homer says . “ I think for the game techs themselves , the symposium really solidified that we are a big community , and we are all here to help each other . They are not on an island doing this work alone .”
ROBERT KRAMER , MD
Co-Medical Director of Digestive Health Institute , Director of Endoscopy , Children ’ s Hospital Colorado
Professor of Pediatrics-Gastroenterology , Hepatology and Nutrition , University of Colorado School of Medicine
ABRAHAM HOMER
Gaming Technology Specialist , Children ’ s Hospital Colorado
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