http://www.straightdope.com/columns/050218.html
Lance: OK, you're giving her an injection of adrenaline straight to
her heart. But she's got breastplates. You've gotta pierce through
that. So what you gotta do is, you gotta bring the needle down in
a stabbing motion. [Makes multiple stabbing motions]
Vincent: I gotta stab her three times?
Lance: No, you don't gotta fucking stab her three times!
You gotta stab her once, but it's gotta be hard enough to get
through her breastplate into her heart, all right? And then
once you do that, you press down on the plunger.
Vincent: OK, then what happens?
Lance: I'm curious about that myself.
Vincent does as instructed. Mia immediately sits bolt
upright, eyes wide open and apparently fully recovered.
OK, this isn't a 100 percent accurate depiction of what would actually
occur. But here's the thing: 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). If the patient is
lucky she revives quickly --epinephrine is the fight-or-flight
hormone that blasts through your system in moments of
extremity. So there's a grain of truth to the scene. But only a grain.
Among the problematic details:
(1) The heart isn't beneath the "breastplate" (presumably Lance
means the breastbone, or sternum--the heart is to the left of this),
and in any case only a fool would try to force a needle through
bone--you'd go between the ribs.
(2) A cardiac arrest victim getting ICI doesn't instantly jerk up like the
alarm clock just went off--the heart might restart right away, but it
would take a while to regain consciousness.
(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.
(4) Epinephrine wouldn't sober up someone who was OD'ing. 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.
ICI is a technique of last resort. Risks include lacerating the coronary
artery and getting air and fluid into places they shouldn't oughta be.
On the other hand, it does make for memorable moviemaking, and
assuming Quentin Tarantino films aren't the primary instructional
tool for ER physicians, what's the harm in that?