They don’t need a GmbH, a UG would do it for less starting capital, BUT a joint stock company does not protect you from Scheinselbstständigkeit per se.

It’s a proper clusterfuck.

Welcome to Germany/Austria,etc.

The issue is not “oh, that will not do good”,but more “does the risk outweight the benefit or not”.

Intubating a patient is always a delicate procedure, doing so with an emergency patient (who obviously has not fasted, has a acute reason for being intubated,etc.) is even more difficult and doing so prehospitally is even more risky. It’s dark, cramped, loud, there are other enviromental factors (I once failed because my hands were shaking to much from the cold), etc. And,in case of a medically assisted intubation before you can intubate you kick out the patients breathing reflexes so they will sure as hell die if you do not suceed. A so called “cannot oxygenate (=Cannot ventilate)/cannot intubate” situation is a nightmarish situation which gives seasoned anaesthesists nightmares. . This makes intubation a skill hard to master - you need around 100 intubations to learn it and 15 per year to keep that skill. Seperatly for adults and children. (The later is even hard to uphold for anaesthesists)

While out tooling has improved and made it FAR easier and safer (videolaryngoskopy, capnography,etc.) than 20 years ago, it is still debatable how safe it is when performed prehospitally. (A recent German study showed a first pass rate - the rate how sucessful a intubation is on first try- of 60% for all professions,including paramedics, anaesthesists,etc.)

Additionally it takes a lot of time - which will occupy a team. While in hospital more people can do other things at the same time. So it’s worth considering “hey,we take 10min of scene time to tube a patient. A hospital is 10 min away. Is jt worth to make a run there and tube then with a better enviroment, while other people can do labs,run blood,etc.?”

The question therefore is more than valid and not as easy to answer - it is always a consideration of patient status, location, resources and enviromental factors. (How bad is the patient? How hard will he be to intubate? How far away from hospital am I? Do I have a intensely trained team I work with every day or am I a solo responder working with a EMT crew that is barely holding it together? How sure am I that I can intubate this patient? How up to the task am I really? How is the truck,the scene?) It’s often a very tough decision. And I saw countless patients die from providers developing a “tuberitis” - the tube needs to go in, no matter what.

Don’t get me wrong - the UK for example has a lack of prehospitally available qualified providers who can properly intubate and I am a old fuck who in doubt will intubate the patient (unless it’s a child, no longer doing these). But I have far more training in that than the average provider. (Currently a high three digit count in the logbook, thanks to working in anaesthesia part time for years)

Source: Am a critical care paramedic, for almost 25 in EMS, have done research on this.

Xwiki is missing.

For me after a similar search it is the current winner. Even though it has it’d downsides. We came from Confluence and tested a LOT of systems. My spreadsheet of systems we considered has around 120 rows by now. (Not all pure wikis as we also moved away from jira and considered going down a “put the wiki into the servicedesk” route)

Pro:

• It is well tested in a enterprise enviromentand mighty

• It has all the features I personally found important for a company wiki, e.g. approval, versioning, templates, collaboration, integration api,etc.

• It is fairly easy to extend it yourself

• It is easy to host subwikis within the same installation with a self defined grade of independence - which is great for customer facing things,large projects with externals,etc.

• The development community is big and enterprise focus and release cycles are good. (Not like a certain .js) There is very little chance it will stall suddenly as the wiki has been adopted by a lot of large companies which seem to support it.

• It’s truely free,no “pay to get custom fields” bullshit.

• It’s truely self hosted.

• it can be hosted system side, if you are not into docker.

Contra:

• It is written in bloody Java

• (even though this sentence is redundant with the one above) It is a resource hog

• The look and feel is a bit outdated unless you customise it yourself. Then it is reasonably good.But there are basically no paid templates,etc.

• Paid support is only available through third parties it seems.

• It can be, well, slow to update…like physically slow. It is not hard to update,not at all…press a few buttons…but sometimes it takes ages.

A follow up is a absolutely regular thing and does not diminish neither study.

Nah, OP is just a troll. Most European countries by now have legislation to mandate them or are currently introducing these. All of them heavily advise them.

This is plain WRONG and DANGEROUS.

The issue is NOT the Americum but the natural degration of the photoelectric cells and the accumulation of dirt within the test chamber.

Even before that time the risk for false alarms is increased substantially by degration before the chances for sucessful alarming decrease rapidly. Due to that they actually withstand aging actually worse than ionisation based devices.

Sientific sources?

Here

here.

Here

Here

(Besides: Americum has a decay time of over 400 years,btw)