Intracardiac injections of drugs was generally used only to provide emergency drugs to a patient if other approaches would be ineffective; for example if drugs could not be administered intravenously due to individual circumstances. The procedure is performed by inserting a long spinal needle into the ventricular chamber. The needle is inserted in the fourth intercostal space between the ribs. Today it is considered obsolete, and other routes to give drugs are preferred (i.e. via an endotracheal tube or intraosseus (direct in the bone))
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The two primary complications are injury to the coronary artery and haemorrhage within the pericardium, or tamponade (constriction of the cardiac blood vessels). The probability of complications can be reduced by using a narrow gauge of needle.
Intracardiac 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, it is used to deliver a dose of adrenaline into Mia Wallace's (Uma Thurman) heart after she overdoses on heroin. It also appears in The Rock, as Stanley Goodspeed (Nicolas Cage) injects a life-saving dose of atropine after inhaling VX nerve gas. In the television series "Firefly", Zoe (Gina Torres) receives an adrenaline shot to the heart in order to revive her after she is gravely injured in an explosion.
- Eldor, J (September 1993). "Immediate intracardiac adrenaline injection in asystole". Lancet 342 (8873): 738–739. doi:10.1016/0140-6736(93)91729-6. PMID 8103835.
- Robert Simon, Barry Brenner (2002). Emergency procedures and techniques. p. 172. ISBN 978-0-7817-2699-3.
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