1 Department of Orthopedics R Adams Cowley Shock Trauma Center University of Maryland Baltimore, MD Department of Anesthesiology University of Maryland School of Medicine Section Trauma Anesthesiology R Adams Cowley Shock Trauma Center Baltimore, MD Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore, MD Department of Orthopedics R Adams Cowley Shock Trauma Center University of Maryland Baltimore, MD North Central Baptist Hospital and Pediatric Orthopedics at Stone Oak San Antonio, TX.