1 Department Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, [email protected] Mountain Track Apps, Philadelphia, Pennsylvania Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, Department of Surgery, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, Department of Surgery, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, Department of Surgery, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.