Quality and Patient Safety Articles-EMG/NCS and Risk of Bleeding

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Electrodiagnostic testing (EMG/NCS) in patients with bleeding disorders carries a greater risk of bleeding compared to the general population. It is advised to exercise caution when deciding on this testing for patients with platelet counts below 50,000 and INR levels above 1.5-2.0. However, there is currently no data available regarding the risks associated with newer anticoagulants or intravenous heparin.<br /><br />A survey conducted in 2006 found that out of 60 academic EMG laboratories, there were 5 serious bleeding complications related to needle electromyography in patients with bleeding disorders. The practices of limiting needle examination varied widely among the participants.<br /><br />Although the risk of symptomatic bleeding is low, physicians performing EMG should remain mindful of potential complications. It is not recommended to routinely stop anticoagulants or antiplatelet medications for EMG, nor should EMGs be routinely deferred in anticoagulated patients.<br /><br />The risk of intramuscular hematoma after needle electromyography is approximately 1.35%. This information is based on a study published in 2017.<br /><br />Source:<br />- "Safety and pain in electrodiagnostic studies" by Z. London, published in Muscle Nerve 55:149-59, 2017.<br />- "Survey of electrodiagnostic laboratories regarding hemorrhagic complications from needle electromyography" by K.L. Gruis et al., published in Muscle Nerve 34:356-58, 2006.

Meta Tag

bleeding

risk

Keywords

Electrodiagnostic testing

EMG/NCS

bleeding disorders

risk of bleeding

platelet counts

INR levels

needle electromyography

symptomatic bleeding

anticoagulated patients

intramuscular hematoma