History Analysis / InstantSedation

* '''Injection or TranquilizerDart.''' It's important to distinguish between ''intravenous'' injection (''i.e.'' directly into the bloodstream) and ''intramuscular'' injection (''i.e.'' wherever the heck you can jam a needle). Intravenous injection of some anesthetics can indeed knock out a person in under 30 seconds, but on TV, your typical sedation target is probably going to resist vigorously, so you can't exactly aim for a vein. Intramuscular injection can take upwards of 15 minutes to take effect; it's evident in safari shows when they shoot an animal but keep trailing it for several minutes waiting for the drug to take effect. Sometimes, to show how tough a character is, he might be shot with multiple needles or darts; this will indeed make the sedative work faster, but again also increases the risk of fatal overdose.\\

Some works might be aware of this and have a character like a doctor stab the victim in precisely the correct spot to give an intravenous injection, which in RealLife can only work with blind luck. Also, some drugs might work intravenously but not intramuscularly, so if you miss, you're just going to cause bad bruising at the minimum. And fiction tends to disregard the fact that there are some ''incredibly stupid'' places to try and stab someone with a needle. Most RealLife tranquilizer darts are [[ShotInTheAss aimed at the rear end]] rather than the neck, as it's much easier to hit.\\

* '''Paralytics''' are not the same as sedatives; a big enough dose of a paralytic drug or gas can actually work kind of similarly to how fiction thinks tranquilizers work. The catch is that paralytics stop all voluntary muscles, ''including the ones that control breathing''. In medicine, they're never used without a ventilator or similar breathing equipment, so using them as InstantSedation will likely kill the victim.

In real life, such gases do exist, but they take a lot longer, and they do run the risk of killing innocents. Dosage is important; it generally takes more to knock out a big tough guy than an InnocentBystander (particularly women and children, who tend to have lower body mass). Works remember this if they want to show how tough a guy is; they forget this when KnockoutGas is used and the first people to be affected are the innocents rather than the rather large and intimidating bad guys. The police in Moscow found this out the hard way when they used knockout gas in [[https://en.wikipedia.org/wiki/Moscow_theater_hostage_crisis the 2002 Moscow theatre siege disaster]]. Also, since the gas is much less concentrated in the air than it would be on a chloroform rag or an anesthesia machine, it tends to be much less efficient than these methods.

In real life, such gases do exist, but they take a lot longer, and they do run the risk of killing innocents. Dosage is important; it generally takes more to knock out a big tough guy than an InnocentBystander (particularly women and children, who tend to have lower body mass). Works remember this if they want to show how tough a guy is; they forget this when KnockoutGas is used and the first people to be affected are the innocents rather than the rather large and intimidating bad guys. The police found this out the hard way when they used knockout gas in [[https://en.wikipedia.org/wiki/Moscow_theater_hostage_crisis the 2002 Moscow theatre siege disaster]]. Also, since the gas is much less concentrated in the air than it would be on a chloroform rag or an anesthesia machine, it tends to be much less efficient than these methods.
* '''Paralytics''' are not the same as sedatives; a big enough dose of a paralytic drug or gas can actually work kind of similarly to how fiction thinks tranquilizers work. The catch is that paralytics stop all voluntary muscles, including the ones that control breathing. In medicine, they're never used without a ventilator or similar breathing equipment, so using them as InstantSedation will likely kill the victim.

While an intravenous injection of some anesthetics can knock out a person in under 30 seconds, an ''intramuscular'' injection -- which is the only kind you're going to get on a person who's resisting vigorously -- can take upwards of 15 minutes or more. Think of all the safari shows where they trail after the tranq'ed wildlife waiting for the drug to finally take effect.

However, this is never fast enough for television -- which has, after all, only 40 minutes (after commercials and credits) to present a [[DramaticHourLong one hour drama]]. Thus, every anesthetic gets upgraded to "instant effect". Exceptions: when the spreading muscular paralysis can be [[BitsOfMeKeepPassingOut played for laughs]] or the writers want to show that a character or animal is extremely tough. In the latter case, multiple darts/injections may be used to speed up the process, apparently without risk of fatal overdose.

Likewise, goons using rags soaked with chloroform or ether to subdue and then kidnap some soon-to-be DamselInDistress is a staple of pulp detective novels, and similar scenes have occurred not infrequently in movies and on television. But in real life, rendering someone unconscious that way not only tends to take several minutes, but also sometimes ''kills'' the intended victim (DontTryThisAtHome. Seriously).

If a mook or a hero wants to sedate a large number of people at once, they may rely on Knockout Gas (which is frequently some [[TechnicolorScience highly visible color, like green or yellow]]). The person doing the gassing might take the effort to put a mask over their own face, but just as often will simply cover their nose. Fortunately for them, Knockout Gas almost always works instantly, and can be highly selective at times, affecting only the intended victims and leaving the gasser and his/her allies alone. In shows and cartoons where gun-like weapons and hypodermic needles aren't allowed, Knockout Gas often becomes the primary weapon of choice for both heroes and villains alike.

These sorts of gases really exist (although slower working), but [[https://en.wikipedia.org/wiki/Moscow_theater_hostage_crisis the 2002 Moscow theatre siege disaster]] demonstrated how dangerous they can be, since the gas which subdued the attackers killed a lot of hostages as well.

It should be noted that administering a drug via inhalation is only marginally slower at getting the drug into the bloodstream than IV injection, and the only reason knockout gas would be much slower than commonly depicted would be because of a relatively low concentration in the air, a directed dose of anesthetic gas (via an anesthesia machine or a rag soaked in a volatile liquid anesthetic) can knock someone out in less than a minute.

Different doses of sedatives vary in effects depending on the body mass of people. So if you put in enough to knock out even the hardiest of people (terrorists tend to be muscular men...), you'll kill some children and women, who have lower body mass. If you use a dose that won't kill anybody, the high-mass people won't get rendered unconscious, and are still dangerous.

Its also important to note that there is a difference between paralytics and sedatives. Large (read: massive) doses of paralytics and paralytic gasses can actually work similarly to the way fiction would like tranquilizers to work. The catch is that paralytics stop all voluntary muscles, including the ones that control breathing. In medicine these are never used without a ventilator or similar breathing equipment on hand, so unless you plan on carrying around a rapid sequence intubation kit and training your mooks to use it, it's a less than perfect solution for your average criminal overlord.

Possibly justified in works set in TheFuture, but we won't know until we get there.

In reality, whilst there are, of course, drugs that can render a person unconscious, the problem lies in the delivery system. A medicine given intravenously (injected directly into the bloodstream) can act on the brain within moments. A drug injected anywhere else (skin, muscle, or fat being the chief alternatives) takes effect in minutes to hours.

Nor is it possible even for a practiced and steady hand to forcibly stab someone with a needle in, say, the neck, and hit an artery or vein. They are quite small relative to the size of the neck, and every person's anatomy is different. A doctor creeping up behind a person with a syringe would hit a blood vessel only by blind luck. The same is true of a tranquilizer dart. Both are used in real life (though the shoulder or the buttocks are used when injecting a person against their will, not, for obvious reasons, the neck.) But they take several minutes, at a minimum, to take effect.

There are also areas of the body where it is ''incredibly stupid'' to stab someone with a hollow needle, while often in fiction this is disregarded. Also the drug make-up for intramuscular serum and intravenous serum can be different depending on the drug, with both IM and IV injections needing to be injected ''carefully'' to avoid bruising and missing the target.

NOTE: There are a few problems with injecting something into an artery which fiction seems to forget sometimes: 1) it will first travel down to the capillary network it supplies before being taken up by the venous network to be returned to the heart, which is incredibly inefficient and will probably damage the peripheral tissues if exposed immediately to a high concentration, 2) arteries have thick external layers of elastic (elastin and collagen fibres) which are difficult to penetrate with a syringe, 3) if you perforate an artery with a syringe, it will bleed, A LOT. Remember folks, there is a reason why it's called intravenous. Veins are your friend. That said, there '''are''' very, ''very'' specific circumstances in which drugs need to be injected into an artery instead of a vein. The needles and drip-ports for administering drugs into an artery require one-way flow valves to prevent the body's own blood-pressure from pushing blood out through the needle and into the syringe and/or tubing, and these drugs are almost '''never''' administered to an outpatient, for obvious reasons.

NOTE: There are a few problems with injecting something into an artery which fiction seems to forget sometimes: 1) it will first travel down to the capillary network it supplies before being taken up by the venous network to be returned to the heart, which is incredibly inefficient and will probably damage the peripheral tissues if exposed immediately to a high concentration, 2) arteries have thick external layers of elastic (elastin and collagen fibres) which are difficult to penetrate with a syringe, 3) if you perforate an artery with a syringe, it will bleed, A LOT. Remember folks, there is a reason why it's called intravenous. Veins are your friend. That said, there '''are''' very, ''very'' specific circumstances in which drugs need to be injected into an artery instead of a vein. The needles and drip-ports for administering drugs into an artery require one-way flow valves to prevent the body's own blood-pressure from pushing blood out through the needle and into the syringe and/or tubing, and these drugs are almost '''never''' administered to an outpatient, for obvious reasons.

These sorts of gases really exist (although slower working), but the 2002 Moscow theatre siege disaster demonstrated how dangerous they can be, since the gas which subdued the attackers killed a lot of hostages as well.

NOTE: There are a few problems with injecting something into an artery which fiction seems to forget sometimes: 1) it will first travel down to the capillary network it supplies before being taken up by the venous network to be returned to the heart, which is incredibly inefficient and will probably damage the peripheral tissues if exposed immediately to a high concentration, 2) arteries have thick external layers of elastic (elastin and collagen fibres) which are difficult to penetrate with a syringe, 3) if you perforate an artery with a syringe, it will bleed, A LOT. Remember folks, there is a reason why it's called intravenous. Veins are your friend. That said, there '''are''' very, ''very'' specific circumstances in which drugs need to be injected into an artery instead of a vein. The needles and drip-ports for administering drugs into an artery require one-way flow valves to prevent the body's own blood-pressure from pushing blood out through the needle and into the syringe and/or tubing, and these drugs are almost '''never''' administered to an outpatient, for obvious reasons.

However, this is never fast enough for television -- which has, after all, only 40 minutes (after commercials and credits) to present a [[DramaticHourLong one hour drama]]. Thus, every anesthetic gets upgraded to "instant effect". Exceptions: when the spreading muscular paralysis can be played for laughs or the writers want to show that a character or animal is extremely tough. In the latter case, multiple darts/injections may be used to speed up the process, apparently without risk of fatal overdose.

NOTE: There are a few problems with injecting something into an artery which fiction seems to forget sometimes: 1) it will first travel down to the capillary network it supplies before being taken up by the venous network to be returned to the heart, which is incredibly inefficient and will probably damage the peripheral tissues if exposed immediately to a high concentration, 2) arteries have thick external layers of elastic (elastin and collagen fibres) which are difficult to penetrate with a syringe, 3) if you perforate an artery with a syringe, it will bleed, A LOT. Remember folks, there is a reason why it's called intravenous. Veins are your friend.

While an intravenous injection of some anesthetics can knock out a person in under 30 seconds, an ''intramuscular'' injection -- which is the only kind you're going to get on a person who's resisting vigorously -- can take upwards of 15 minutes or more. Think of all the safari shows where they trail after the tranked wildlife waiting for the drug to finally take effect.

Likewise, goons using rags soaked with chloroform or ether to subdue and then kidnap some soon-to-be DamselInDistress is a staple of pulp detective novels, and similar scenes have occurred not infrequently in movies and on television. But in real life, rendering someone unconscious that way not only tends to take several minutes, but also from time to time kills the intended victim (DontTryThisAtHome. Seriously).

If a mook or a hero wants to sedate a large number of people at once, they may rely on Knockout Gas (which is frequently some [[TechnicolorScience highly visible color, like red or yellow]]). The person doing the gassing might take the effort to put a mask over their own face, but just as often will simply cover their nose. Fortunately for them, Knockout Gas almost always works instantly, and can be highly selective at times, affecting only the intended victims and leaving the gasser and his/her allies alone. In shows and cartoons where gun-like weapons and hypodermic needles aren't allowed, Knockout Gas often becomes the primary weapon of choice for both heroes and villains alike.

These sorts of gases really exist (although slower working), but the most recent attempted use in the 2002 Moscow theatre siege was a disaster, killing a lot of hostages as well.

Its also important to note that there is a difference between paralytics and sedatives. Large (read massive) doses of paralytics and paralytic gasses can actually work similarly to the way fiction would like tranquilizers to work. The catch is that paralytics stop all voluntary muscles dead, which includes the ones that work your lungs. In medicine they are very useful when you are standing by to take over the job of breathing for the person, but unless you plan on carrying around a rapid sequence intubation kit and training your mooks to use it, it's a less than perfect solution in real life.

Possibly more realistic in series set in TheFuture, but we won't know until we get there.

Also note that in general, a medication which produces perfect unconsciousness also produces apnea -- which is to say, the victim stops breathing. Calming a person with a sedative is one thing -- but the total oblivion seen in TV and movies is typically only induced by the medical profession when they intend to support the patient's breathing via a bag-valve mask or a ventilator.