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Supine trauma radiograph demonstrating a large left sided haemothorax. Although the patient is slightly rotated, there seems to be shift of the mediastinum to the right due to increased volume in the left hemithorax. There are bilateral posterior rib fractures and additional displaced fractures of multiple left ribs laterally producing a flail segment. There is left chest wall subcutaenous emphysema. A pneumocath inserted by paramedics is seen in entering the chest cavity via the left 2nd anterior intercostal space.