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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.

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  • Appeared also in "The Rock" (see also en.wikipedia.org/wiki/Intracardiac_injection). Perhaps the references there could be enough to create an answer? – Suma Jun 12 '12 at 8:54
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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 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
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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).

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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 6 '13 at 22:53

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