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Introduction: The optimal pathway for ultra-early diagnostics and treatment in patients with acute stroke remains uncertain. The aim of this study was to investigate how three different methods of simulated, rural prehospital computed tomography (CT) affected the time to prehospital treatment decision in acute stroke., Materials and Methods: In this pragmatic, simulation, pilot study of prehospital CT we investigated a conventional ambulance with transport to a standard care rural stationary CT machine managed by paramedics, a Mobile Stroke Unit (MSU), and a helicopter with a simulated CT machine. Each modality completed 20 real-life dispatches combined with simulation of predetermined animated patient cases with acute stroke symptoms and CT images. The primary endpoint of the study was the time from alarm to treatment decision., Results: Median time from alarm to the treatment decision differed significantly between the three groups ( p  = 0.0005), with 38 min for rural CT, 33 min for the MSU, and 30 min for the helicopter. There was no difference in time when comparing rural CT with MSU, nor when comparing the MSU with the helicopter. There was a difference in time to treatment decision between the rural CT and the helicopter ( p  < 0.0001). The helicopter had significantly lower estimated time from treatment decision to hospital ( p  = 0.001)., Disscussion/conclusion: Prehospital CT can be organized in several ways depending on geography, resources and need. Further research on paramedic run rural CT, MSU in rural areas, and helicopter CT is needed to find the optimal strategy., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Despite the lack of knowledge about the SARS-CoV2 virus, the lack of personal protection gear among frontline healthcare workers, and lack of vaccines in the beginning of the pandemic, paramedic students in Norway contributed to the National response against the COVID-19 pandemic by working in test-stations, ambulance services, ambulance decontamination stations etc. Despite fear of contracting the COVID-19 reported by healthcare workers worldwide, paramedic students in Norway reported higher-than-average quality of life after four months of the COVID-19 pandemic (first pandemic wave). In this study we aimed to investigate how students reported their quality of life, study motivation and job satisfaction after one year of living with the COVID-19 pandemic., Method: At two data collection point, all paramedic students enrolled at Oslo Metropolitan University were invited to participate in a digital, online, self-administered survey. The first data collection was in June 2020 (the first pandemic wave), while the second data collection was in March 2021 (the third pandemic wave). Results from both samples were analyzed independently with descriptive statistics. Differences between the groups were analyzed using an independent T-test and Mann-Whitney-U test to discover changes over time. Multiple linear regression analysis was used to estimate the difference attributable to timing (first vs. the third wave), seniority, and student gender., Results: The samples consist of slightly more female students than male students. The mean age in both samples is 24.6 years. Despite the higher-than-average level of quality of life in the first pandemic wave, results show that there was a significant reduction in students' health-related quality of life (p < 0.001, B -0.059, SE 0.016), study motivation (p = 0.002, 95% CI:0.09,0.41), and job satisfaction (p = 0.005, 95% CI:1.62,9.00) after the third pandemic wave in Norway. Surprisingly, students experienced more technical challenges in the third wave, e.g., poor internet connection, sound pollution, and poor picture quality, despite more experience among students and teachers., Conclusion: Our results show that paramedic students had significant worsening experiences in the late pandemic wave compared to the first pandemic wave. Universities and governments should learn from the COVID-19 pandemic to develop better preparedness plans for future pandemics and knowledge about students' well-being should be considered in future preparedness plans for higher education and the government plans for the education of front-line healthcare workers during a pandemic to facilitate the continuation of necessary education., (© 2023. The Author(s).)