A 14 month old male stuck a fork in an outlet. It made a big spark and he cried. The wall looks a little toasted, but the boy appears to be doing fine. Mom “just wanted him checked out.”
Is he OK?
Yes – If he looks good in the ED then he’ll look good later for the most part. Obvious thermal burns are often apparent early on (at least in the form of pain). And if he were to suffer adverse cardiac effects it would be V fib most likely – and he wouldn’t be presenting to you in an exam room with a mom “just wanting him to be checked out.”
Does he need an EKG?
Survivors of high energy shocks (>1,000 volts) definitely need an EKG. The significnace of injury is related to the amount of current flowing through the body. Contact with a 120 V circuit carrying a 1 milliampere (mA) current is imperceptible to most, 3 mA leads to mild tingling, and 10-12 mA leads to pain. One hundred mA directed across the heart could lead to V. fib. Wall sockets in the US are generally 100 or 125V and 15-20 A. So home outlets are generally not going to lead to cardiac effects.
Does he need any other tests?
Though high voltage injuries are at risk for cardiac effects as well as rhabdomyolysis, this patient does not need cardiac enzymes, CMP, or urinalysis to look for myoglobin.
Could anything bad happen later?
Nope – unless he does it again.
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