• Emmanuelle C Issa, Peyton J Ware, Paula Bitange, Garrett J Cooper, Tori Galea, Deena I Bengiamin, and Timothy P Young.
• Laboratory for Innovations in Medical Education (LIME), Loma Linda University School of Medicine, Loma Linda, California.
• J Emerg Med. 2023 Mar 1; 64 (3): 400404400-404.

BackgroundLumbar puncture is a procedure that is commonly performed in emergency departments. Despite their absence from procedure kits, emergency physicians often use skin markers to delineate landmarks for a lumbar puncture. We prefer to create a temporary indentation in the skin using the suction of a syringe. This "syringe hickey" eliminates the need for a skin marker.DiscussionWe created a photo demonstration comparing the syringe hickey to a skin marker for site marking. The syringe hickey was created using a 10-mL syringe aspirated to 5 mL on the forearm for 1 min. The syringe hickey lasted over 30 min on a range of skin tones across the Fitzpatrick Scale. The skin marker faded but the syringe hickey maintained its definition after application of ultrasound gel and sterilization with either chlorhexidine or betadine.ConclusionsThe syringe hickey is a simple skin marking technique that is resistant to antiseptic agents and ultrasound gel. The syringe hickey may be useful for other procedures that require puncture site marking.Copyright © 2023 Elsevier Inc. All rights reserved.

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