R. B. is a 49yo male who presents after a fall down 14 stairs. After hitting the concrete basement floor face first, his wife calls the squad who immobilizes him in the position found. He states he passed out prior to the fall. Edentulous, with blood at nares and mouth. Significant myoclonic spasms.
Facial views reveal bilat.
Comminuted nasal fracture. Fracture of pterygoid plates. Left mandible fracture x2. Possible occult right orbital floor fracture. Taken off backboard and given suction catheter to control secretions.