We describe the case of a previously healthy toddler with the finding of supraventricular tachycardia after being rescued from a garage fire. The patient's initial presentation was concerning for inhalational injury and a 2% total body surface area burn to the forehead. Additionally, the patient was noted to be extremely agitated in the trauma bay. Given the patient's agitation and the mysterious circumstances surrounding the fire, a urine toxicology was performed shortly after admission and was positive for cocaine. Passive cocaine inhalation, possibly during the fire, is a likely explanation for the child's arrhythmia.