In response to federal legislative reform aimed, in part, at reducing consumer bankruptcy filings, the authors conducted 2 experiments examining the role of affect in purchasing behavior. In Experiment 1, they examined consumer debtors, and in Experiment 2, they examined nondebtors. In both experiments, they investigated purchasing decisions made during a simulated online shopping trip, with some participants receiving standard disclosures of interest rates and money owed and with other participants receiving information under the new enhanced disclosure regulations. Results demonstrated support for the influence of anticipated affect in credit card use among both debtors and nondebtors and indicated that anticipated emotion may moderate the impact of the enhanced disclosure regulations.

This study demonstrates a lower intubation rate in patients administered ketamine than prior literature in association with a lower weight-based dosing regimen. Ketamine use was correlated with a higher frequency of intubation and a greater need for additional chemical restraint when compared with other restraint modalities, though exogenous factors such as provider preference may have impacted this result. There was no difference in ED length of stay or admission rate between the ketamine and haloperidol plus benzodiazepine groups. Further prospective study is needed to determine whether there is a subset of patients for whom ketamine would be beneficial compared to other therapies.

Severe forms of sepsis are major contributors to morbidity and mortality worldwide, with mortality rates as high as 25%-60%. 1 Sepsis with hypotension and septic shock, which we define as sepsis with a systolic blood pressure ≤ 90 mm Hg that is refractory to an initial fluid bolus, 2 are important subsets of sepsis and are medical emergencies for which timeliness of care is crucial. The literature demonstrates that early administration of antibiotics provides a significant mortality benefit in both conditions. 1 Emergency medical services (EMS) personnel treat the majority of sepsis with hypotension and septic shock cases. 2 Consequently, oversight entities, including the Centers for Medicare & Medicaid Services, are recognizing that EMS providers are an important link in ensuring timely care for patients with sepsis. 3 A natural extension of current initiatives to reduce time to antibiotic administration in patients who exhibit sepsis with hypotension or septic shock is to consider implementing prehospital administration of antibiotics.Research regarding the feasibility of this practice and its effectiveness has primarily been performed in Europe. [4][5][6] Few American systems have begun examining similar prehospital antibiotic administration protocols. 7,8 These early studies have demonstrated evidence of improved patient outcomes including shorter intensive care unit (ICU) lengths of stay. 7,8 The primary aim of our investigation was to describe the safety and feasibility of a protocol for prehospital recognition of sepsis with hypotension and septic shock, drawing of blood cultures, and administration of intravenous (IV) antibiotics in an urban EMS service, thereby adding to the limited U.S. literature available on this subject and supporting the development of a large-scale randomized control trial (RCT). Primary feasibility measures included the frequency of allergic reactions, culture contamination, and paramedic adherence to the protocol in the prehospital environment. Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) were used to report the findings of this preliminary result. 9This pilot study was conducted at a large urban academic medical center under a state-granted special project waiver for the protocol implementation. This two-armed project consisted of a retrospective chart review for the historical cohort and a prospective observational study for the interventional arm.

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