When a Stroke is Possible, Experience Makes the Difference

fdab34b21455786ec5d7_Dr._Gary_Belt_2017.jpg
Gary Belt, MD, stroke neurologist, Overlook Medical Center
0020e7ff7bc673209cc3_877d0e368938480ea5e8_Angela_McCall-Brown__nurse_practitioner.jpg
fdab34b21455786ec5d7_Dr._Gary_Belt_2017.jpg

When it comes to accurately diagnosing whether someone has suffered a stroke, “one can never be too smart,” says Dr. Gary Belt.

Belt, a stroke neurologist at Atlantic Neuroscience Institute in Overlook Medical Center, has more than three decades of experience in making those tricky diagnoses. He knows that superficial signs that seem to indicate a stroke can’t always be trusted and that a stroke neurologist must think like a detective.

In a presentation he titled “Stroke Mimics,” Belt recently spoke to a roomful of nurses at the 2017 Atlantic Health System Neuroscience Nursing Symposium. His goal: To help them become more adept at what he called “the stroke or no-stroke game.”

Sign Up for E-News

Getting it right is crucial, because an accurate diagnosis – and the quick administration of the clot-busting drug Alteplase (tPA) – can have wonderful results.

“Since the mid-1990s, we’ve had a drug called tPA which, essentially, is like Drano for a blood vessel,” Belt said. “We know that if we open the vessels quickly enough, we can prevent a stroke or keep the damage from a stroke to a minimum.”

The nurses listening to Belt were all trained in The National Institutes of Health Stroke Scale (NIHSS) test. Nurse practitioner Angela McCall-Brown, an expert in the NIHSS, also spoke at the symposium, relaying anecdotes that showed the importance of medical staff experience and knowledge during that first observation.

In addition to carefully assessing the cognitive capabilities of possible stroke patients, nurses must dutifully follow – in a specific order – the NIHSS tests of motor skills. These include having patients do simple tasks such as touching their noses, holding their arms out and rubbing one heel against the opposite shin.

In addition to carefully assessing the cognitive capabilities of possible stroke patients, nurses must dutifully follow – in a specific order – the NIHSS tests of motor skills. The value of speed in performing the NIHSS comes to play in helping doctors decide when patients should be treated with tPA.

Both Belt and McCall-Brown said they are sometimes surprised by the effectiveness of fast treatment.

“I had a patient … They brought her into Overlook Medical Center emergency department and she was totally mute,” McCall-Brown said. “She could sit and look at us and she was shaking her head, but she was not saying anything.”

The woman was administered alteplase and while the stroke team monitored the patient, McCall-Brown left the Emergency Room.

“I went back upstairs, saw some more patients on the unit, and came back downstairs to the emergency department,” she said. Knowing the patient could not speak, she started talking to the family.  I said, ‘So how’s everybody doing? My name’s Angela.’ And the patient says, ‘I’m much better now.’”

The opinions expressed herein are the writer's alone, and do not reflect the opinions of TAPinto.net or anyone who works for TAPinto.net. TAPinto.net is not responsible for the accuracy of any of the information supplied by the writer.

TAP Into Another Town's News:

You May Also Be Interested In

Sign Up for E-News

Madison

F.M. Kirby Children’s Center of the Madison Area YMCA Students Sing, Dance and Laugh to the Music of Lovey Williams

April 16, 2018

Lovey Williams created joyful noise and music with the students of the F.M. Kirby Children’s Center of the Madison Area YMCA to kick off the Week of the Young Child that runs through Friday April 20. Students engaged in music by singing, dancing and playing instruments to their favorite songs at their annual Lovey Williams Concert. The Week of the Young Child celebrates early learning, ...

AtlantiCast

AtlantiCast: Episode 14

On this week’s AtlantiCast, an internationally recognized orthopedic oncologist takes a leadership role at Atlantic Health System, see the newest weapon in the fight against HPV-related cancers, Atlantic Health System leads the Castle Connolly / Inside Jersey Rankings, and much more!

 

Letter to the Editor: Don't Complain. Vote!

April 14, 2018

Don’t Complain; Vote!

It’s no secret that people have strong feelings about what’s happening in our country. It’s also true that much of politics is local. In November, 11th District residents will have the opportunity to choose a new congressional representative who will not only serve as a critical check on the federal level, but also determine how our distract fares ...