Intracardiac injection
Intracardiac injections are injections
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...

 that are given directly into the heart muscles or ventricles. They are used in emergencies.


Intracardiac injections of drugs are generally used only to provide emergency drugs to a patient if other approaches would be ineffective; for example if drugs cannot be administered intravenously due to individual circumstances. The procedure is performed by inserting a long spinal needle into the ventriclular chamber
Ventricle (heart)
In the heart, a ventricle is one of two large chambers that collect and expel blood received from an atrium towards the peripheral beds within the body and lungs. The Atria primes the Pump...

. The needle is inserted in the fourth intercostal space
Intercostal space
The intercostal space is the space between two ribs . Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.-Structures in intercostal space:* several kinds of intercostal muscle...

 between the ribs.


The two primary complications are injury to the coronary artery and haemorrhage within the pericardium
The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.-Layers:...

, or tamponade
Tamponade is the closure or blockage as if by a tampon especially to stop bleeding.Tamponade is a useful method of stopping a hemorrhage...

 (constriction of the cardiac blood vessels). The probability of complications can be reduced by using a narrow gauge
Needle gauge comparison chart
Hypodermic needles are available in a wide variety of outer diameters described by gauge numbers. Smaller gauge numbers indicate larger outer diameters. Inner diameter depends on both gauge and wall thickness. The following chart shows nominal inner diameter and wall thickness for regular-wall...

 of needle.

Popular Culture

Itracardiac injection has appeared several times in the media, although artistic liberties surrounding the procedure are common. In a famous scene in the film Pulp Fiction
Pulp fiction
Pulp fiction may refer to:* pulp magazines, short stories presented in a magazine format, printed on cheaply made wood-pulp paper* Pulp Fiction, a 1994 film directed by Quentin Tarantino...

, it's used to deliver a dose of adrenaline into Mia Wallace's (Uma Thurman
Uma Thurman
Uma Karuna Thurman is an American actress and model. She has performed in leading roles in a variety of films, ranging from romantic comedies and dramas to science fiction and action movies. Among her best-known roles are those in the Quentin Tarantino films Pulp Fiction and Kill Bill...

) heart after she overdoses on heroin. It also appears in The Rock
The Rock (film)
The Rock is a 1996 action film that primarily takes place on Alcatraz Island and in the San Francisco Bay area. It was directed by Michael Bay and stars Sean Connery, Nicolas Cage and Ed Harris. It was produced by Don Simpson and Jerry Bruckheimer and released through Hollywood Pictures. The film...

, as Stanley Goodspeed (Nicholas Cage) injects a life-saving dose of atropine
Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...

 after ingesting VX nerve gas.
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