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As a retired United States Air Force pilot-physician, I commend Singh et al for their excellent use of situational awareness as an analysis tool in aviation.1 I wish only to add a subtle dimension to their illustration of situational awareness: LSA (loss of situational awareness) began as a universally recognised acronym of the North Atlantic Treaty Organization. But one cannot lose what one never had. Situational awareness in military and air carrier aviation universally begins at a maximum, and may deteriorate backwards from level 3 of Endsley’s model. Maximal situational awareness at …
Competing interests: None.