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Natural and man-made disasters will remain a threat to the safety and health of communities in all parts of the world, especially within vulnerable communities in LMICs; however, little research has been done to identify disaster perception, vulnerability, and preparedness in LMIC communities. The current study established that selected communities near Trujillo, Peru recognize a high disaster impact from earthquakes and infection, but are not adequately prepared for potential future disasters. By identifying high-risk demographics, targeted public health interventions are needed to prepare vulnerable communities in the following areas: emergency food supplies, emergency water plan, medical supplies at home, and establishing evacuation plans. Stewart M , Grahmann B , Fillmore A , Benson LS . Rural community disaster preparedness and risk perception in Trujillo, Peru. Prehosp Disaster Med. 2017;32(4):387-392.

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Anaesthetic Awareness is the recall of events that occur during sedation and is a serious complication thought to occur in 0.1 to 0.2 % of the general surgical population. Sedation is an important tool used in medical retrieval, however its use in the aerospace environment is unique in its challenges for clinicians. Many of the patients carry risk factors for anaesthetic awareness and the mode of anaesthesia appropriate for the aerospace environment, total intravenous anaesthesia, also carries a higher risk compared to other methods. In addition the aerospace environment has other challenges not specific to sedation including noise distractions and the physiological effects of high altitude on patients which can impact on the ability to provide adequate sedation. Given all this, patients receiving sedation during medical retrieval would seem to be at a higher risk of anaesthetic awareness than many of their counterparts on the ground. For many high risk patients in hospitals technology such as brain monitoring has been shown to be effective in reducing awareness. Therefore as patients in the air are as likely, if not more likely to be at risk of awareness the use of this aid in medical retrieval is raised for consideration. However this technology will only ever be an adjunct to clinical expertise and an overall understanding of the flight environment and its challenges will allow for best patient care possible and the reduction of awareness during sedation.

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