Question to medical professionals or just smart people: When you see a movie where a character

[Mike 03]

suffers a huge physical trauma of some sort, and a doctor quickly and violently stabs a syringe into their upper chest, what is he/she injecting? And why? Does it stop the pain or put them to sleep or does it keep the heart pumping or what?

Thanks in advance. This has puzzled me for a long time.

ON EDIT:

Yes, it's a movie. But if this were real life, what would be in the syringe. Thanks.

[Pierre.Suave]

1. Probably not injecting anything

more likely letting any air (gas) or blood escape to prevent undue pressure on the lungs so the person can breathe.

edit: and then it is probably off to surgery to fix whatever is causing the problem...

[siligut]

14. It isn't a quick stab procedure, but...

I have seen blood drained with a needle from around the heart in cases of pericarditis. The blood can build up between the pericardium and the myocardium, compressing the heart muscle so it can’t relax and fill with blood.

[Pierre.Suave]

15. yeah, of course

but this is also tv we are talking about here.

[siligut]

16. You know, when TV gets even basic medical stuff wrong it bugs me.

I wonder why they don’t consult someone who knows about medical procedures before they do something really inane. You know, like nasal cannulas that go behind the neck, really stupid stuff. Maybe you could offer your services to scriptwriters, there ought to be a position like that.

[trof]

2. Injecting nothing. It's just a movie. It's all fake.

:rofl:
Oh, what does it represent?
Who knows.

[Mike 03]

3. Lol, touche.

I should have been more clear.

:rofl:

[DS1]

4. adrenaline

[Pierre.Suave]

5. LOL

straight into the heart for maximum effect...

:rofl:

[siligut]

8. Sometimes just smacking them real hard on the chest can do it.

A chest thump for someone in VTach can bring them out.

[DS1]

9. I always wondered about a beating heart tearing itself to pieces with a needle in it

:shrug:

[siligut]

11. I can understand that.

Basically it is used for a heart that isn’t beating, that is why it is needed. I just added the Vtach chest thump for the fun of it, which seems just as strange really.

[triguy46]

18. If it were beating, you wouldn't do it.

[GCP]

13. I thought you were a med student

Haven't you ever heard of this?

[siligut]

24. I feel the need to respond to this.

As monsieur Suave chose not to. It is not a common procedure. Expecting a med student or even a person who is already a physician to know everything is a common and very unrealistic belief. This is one of the reasons Drs specialize.

[GCP]

25. So why did he feel the need to laugh at DS1's post

Some of us, who aren't med students knew of this procedure.

[siligut]

26. Maybe it is a personal thing.

I don't know. Medical training is extreme, just like law school. You are asked arbitrary questions and berated if you don't know the answer. I was responding to your specific post, not as revenge of any sort, just as clarification.

[Pierre.Suave]

27. I laughed more at the thought of someone VIOLENTLY STABBING, per the OP,

a needle straight into someones heart than the actual procedure of injecting Epinephrine (adrenaline) into someones heart to jump start it, which would not be done violently.

Also, as noted above by Siligut and others below, this is a very uncommon procedure nowadays.

[suninvited]

28. pierre.suave a med student?

lol

I have never heard that one. Did I miss something? I think he is posting on DU way too much day and night to be a med student.

[siligut]

6. Adrenaline can be injected directly into the heart.

It is to get the heart to pump. http://www.aspenpharma.com.au/PDF/CMI/CMI_Adrenaline.pdf I also seem to remember adenosine being injected directly, it is the energy needed to make the muscle contract, however, I can't find a link for it.

[HopeHoops]

7. They use a cardiac needle that's about the size of a chain saw, but I'm not sure what they inject.

[carlyhippy]

10. well...according to Pulp Fiction....

it's a syringe full of adrenaline inserted into the heart with one stab, only after consulting your little black medical book that should be kept with the honking huge syringe and adreline.

[ghostsofgiants]

21. That's only f you hang around with bubblegummers who can't handle their drugs, though.

[carlyhippy]

22. but helpful info if someone brings a f**ked up poo-bah to the house

Carly

[trof]

12. epinephrine

Therapeutic use:

Epinephrine is used as a drug to treat cardiac arrest and other cardiac dysrhythmias resulting in diminished or absent cardiac output; its action is to increase peripheral resistance via α1-adrenoceptor vasoconstriction, so that blood is shunted to the body's core, and the β1-adrenoceptor response which is increased cardiac rate and output (the speed and pronouncement of heart beats). This beneficial action comes with a significant negative consequence—increased cardiac irritability—which may lead to additional complications immediately following an otherwise successful resuscitation. Alternatives to this treatment include vasopressin, a powerful antidiuretic which also increases peripheral vascular resistance leading to blood shunting via vasoconstriction, but without the attendant increase in myocardial irritability.<5>

Due to its suppressive effect on the immune system, epinephrine is the drug of choice for treating anaphylaxis. It is also useful in treating sepsis. Allergy patients undergoing immunotherapy may receive an epinephrine rinse before the allergen extract is administered, thus reducing the immune response to the administered allergen. It is also used as a bronchodilator for asthma if specific beta2-adrenergic receptor agonists are unavailable or ineffective.

Because of various expression of α1 or β2-receptors, depending on the patient, administration of epinephrine may raise or lower blood pressure, depending whether or not the net increase or decrease in peripheral resistance can balance the positive inotropic and chronotropic effects of epinephrine on the heart, effects which respectively increase the contractility and rate of the heart.

Epinephrine can also be found in some brands of nasal spray. Its use in this form is to open air passages, however short-term this use may be.

Miz t. is allergic to epinephrine. It is usually administered in combination with xylocaine to deaden dental gum and tooth root tissue during dental procedures. This epinephrine application minimizes bleeding. It gives her palpitations/tachycardia (rapid heart beat) .
TMI?
:shrug:

[triguy46]

17. Seen it many times, not so much in the past decade, but....

a whole bunch of times 20-30 years ago. Rarely worked, but it makes for a helluva show. And the sound is pretty good too. Not as good as the 'pop' of a trochar piercing the space between ribs to insert a chest tube, but pretty good nonetheless.

Let me testify, that after 33 years in healthcare, TV is not even close to the drama, the humor, the poignancy, the joy, and the tragedies that the real world offers. TV medical shows are a joke.

[Tuesday Afternoon]

20. Agreed. I can not watch any of the medical shows for this reason.

Not House. Not ER. Not even Scrubs. Not even the one where the 2 brothers are Plastic Surgeons. It just bugs me. I figure I might as well be at work.

[bmbmd]

19. Intracardiac epinephrine is pretty impressive.

Pericardiocentesis (to remove fluid from around the heart in the pericardium-often blood after blunt or sharp chest trauma) is sometimes used in the emergency room. Occasionally, a large bore needle (like a spinal needle) can be inserted in to the pleural space to relieve pressure from a tension pneumothorax if no chest tube is immediately available. These are big league procedures,
but not nearly as impressive as "cracking the chest". That's just what it sounds like-exposing the heart to suture or clamp an exsanguinating hemmorhage.

[Tuesday Afternoon]

23. The thing is ....chest tubes are readily available in most ERs.

My experience anyway. :shrug: