I was watching one of my favorite movies, Pulp Fiction, again tonight, and in true doper fashion, I had a question about one of the parts of the movie.
In the movie, Mia Wallace snorts some of Vincent’s “mad man” heroin, thinking it is cocaine. She OD’s on the stuff. and is apparently almost dead.
Needless to say, the cure was to give her an adrenaline shot straight into her heart. Vincent jabbed a huge syringe into her heart, and plunged the adrenaline in. In the movie, of course, she “woke up” startled, and was fine thereafter.
Can anyone in the medical practice say if this was a valid treatment for this type of drug overdose, or was this purley (pulp) fiction?
bolding mine
But it doesn’t specify just what counteracting drug to use as an antidote. Eureka!
bolding mine
So, my buddy Ben didn’t have to be wrapped in a blanket & dumped in the river by his junkie “friends” 9 years ago
Which left me wondering if nalorphine is related to epinephrine or norepinephrine (adrenaline), so I looked here
Interesting…Using a derivative of dope to treat an overdose of dope…
Still no info re: the giant hypo rig. I already knew that they don’t stab through the sternum (Tarantino had Stolz call it a “breastplate”) but go between the ribs for a direct injection to the heart. I have heard of such an injection being done to restart a stopped heart before, but don’t know if this is ever done for a heroin OD.
Based on my research so far, I’m calling bullshit on Tarantino. It’s still a great movie though.
Naloxone (Narcan), another narcotic antagonist (possession of which is generally a good indicator of a habitual heroin user), is indicated for subcutaneous, intravenous, or intramuscular use. Nothing suggests that it can be administered via intracardial injection.
Intracardial injections of epinephrine might be administered to a overdose victim who is flatlining, if compression and/or defibrillation don’t work. However, it would be to prevent cardiac arrest caused by the overdose, not to treat the overdose itself.
That movie scene was a gross example of medical mistreatment. :eek: I was hollering those very words at the movie screen when I saw it! (which got me some strange looks, let me tell you!)
Anyway, the most likely clinical scenario from an overdose of heroin would be respiratory arrest. Not cardiac arrest. What that gal needed was a dose of an opiate antagonist such as naloxone, right quick, to knock the heroin out of the opiate receptors and let her resume breathing.
However, if I had no other meds available except epi, I suppose I would consider injecting epi, and performing rescue breathing, to see if I could stabilize her enough that way.
And frankly, intracardiac injection, though not the desired route, would be effective. It just has a hell of a lot more risks associated with it. I’ve never done intracardiac injections on anyone who wasn’t about to be dead without drastic intervention.
Yeah, over the top, but Qadgop, they’re drug addicts. A bunch of half-addled, freaked out, panicked junkies and dealers will do weird, peculiar and even really dumb stuff. Sure, the medicine was crap, but the running around and hollering sure captured the emotion of the moment. Not to mention that lovely bit where Vicent drops Mia face down on the lawn like a sack of dirty laundry to argue his point with gestures as well as voice.
I didn’t think the “treatment” meshed with reality, nor did I think she’d be walking back into her house under her own power just a short while later if it was all real life - but it wasn’t real life. At the time the movie came out in the theaters, I was still working at the clinic and we did have some concern that some our “clients” would do something of the sort. Because they did do weird, inexplicable, bizarre things from time to time.
I’ve been having this same question recently, and fighting with a friend over its validity. After much research I found a nursing website which talks about its potential use as a last resort- not favorable but possible.
“If venous access cannot be obtained and the patient is intubated, adrenaline can be given via the endotracheal tube directly into the lungs. Manufacturers suggest that adrenaline may be injected directly into the heart through the chest wall if no other route is available (eMC, 2006). This can be a difficult procedure and should only be attempted by a competent clinician and when all other attempts to gain access have failed.”
The scene in Pulp Fiction was inspired by a story told in the 1978 documentary American Boy: A Profile of Steven Prince directed by Martin Scorsese. Here is the scene from the documentary juxtaposed with the scene from Pulp Fiction followed by a later interview with Prince. I don’t know if Prince was telling the truth, but this is where Tarantino got the idea.
Earlier thread started by me on the same topic. Eleven years earlier. This place is getting old. **QtM **relates more of what he yelled at the movie screen in the earlier thread.
While you could make a case for a last ditch ‘the pt was as good as dead anyway,’ injection of epi into the heart, the pt emphatically would not sit up, gasp and then be able to walk to the car.
