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I wonder if the scene in the movie Pulp Fiction, where a girl (Marsellus Wallace's wife), in a bad health situation after taking too much heroin, is brought to life by a direct prick of adrenalin in her heart is a real "medical" practice or it's just a joke from the scenarist.

Jamiec
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Rabskatran
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  • Appeared also in "The Rock" (see also http://en.wikipedia.org/wiki/Intracardiac_injection). Perhaps the references there could be enough to create an answer? – Suma Jun 12 '12 at 08:54
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    The practice is real as far as I know, but the needle used is vastly different from the one portrayed in Pulp Fiction – Ryathal Jun 12 '12 at 12:26
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    I can not think of any problems that could arise from jabbing a giant needle into a random area of the heart in a non sterilized environment... – Chad Jun 12 '12 at 13:03
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    @Chad: If my heart has stopped, please jab a giant needle into my heart area before worrying about the sterility of the environment. I'd rather worry about infection later, than not worry about anything at all. – Flimzy Jun 12 '12 at 14:44
  • [TV Tropes](http://tvtropes.org/pmwiki/pmwiki.php/Main/ShotToTheHeart) has this to say: *While epinephrine (adrenaline) is used to treat several ailments from anaphylactic shock to cardiac arrest, no doctor since about 1990 would ever treat a patient by stabbing them in the heart with a giant needle... [I]f the heart was completely stopped and only if every other option was exhausted. In a modern hospital, if you need a drug to get to the heart quickly, it goes into a vein, with chest compressions used to move the blood in the event of cardiac arrest.* – Chad Jun 12 '12 at 16:26
  • @Flimzy so if I need to give you andrenaline(while you are probably good and properly screwed if you need me to do it) I will stick in in the vein in your arm or leg.(probably leg for me since it is larger and easier to stick) – Chad Jun 12 '12 at 16:27
  • I am an ER doctor and have never given an intracardiac injection of any medication. I have run and assisted with 100s of cardiac arrest and have never seen or heard of it being done, other than in the movies. This would be very dangerous and could lead to a pneumothorax, coronary artery injury, or pericardial tamponade. –  May 24 '13 at 04:24

1 Answers1

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There's a Straight Dope column that covers this question, it notes that there is an element of truth to the scene:

doctors honest to God do on (rare) occasion jab a big hypodermic of epinephrine, AKA adrenaline, directly into the heart of someone who's gone into cardiac arrest, a technique called intracardiac injection (ICI).

I found a few articles on ICI:

The Straight Dope article goes on to point out a number of inaccuracies with the scene, including:

3: Mia's problem probably isn't cardiac arrest anyway — the immediate consequence of heroin overdose is severe respiratory depression. As long as her heart keeps beating, ICI is pointless. If Mia needs an injection of something, a plain old intravenous shot will work just fine, since her blood is still circulating.

National Institute of Health - Heroin overdose

4: Epinephrine wouldn't sober up someone who was ODing. To neutralize heroin you'd administer a drug such as Narcan (naloxone), which blocks the opiate receptors in the brain and can bring a junkie back to earth in a matter of minutes.

British Medical Journal - Degree and Duration of Reversal by Naloxone of Effects of Morphine in Conscious Subjects

Finally, for a more realistic portrayal of heroin overdose I'd recommend this scene from Trainspotting note - contains swearing (and drug use).

Tom77
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  • even on the *very very rare* case that a doctor may actually resort to an intracardiac injection, they world be *far more careful and precise* than the standard "jab the big needle somewhere near the heart" scene. – KutuluMike Jun 06 '13 at 22:53