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This image displays a large left sided haemothorax with mediastinal displacement to the opposite side. Clinically the patient would be in respiratory distress - percussion of the left side of the chest would be dull and breath sounds and vocal resonance would be reduced. A Haemothorax such as this falls into the category of life threatening chest injuries (ATOMFC) and requires emergent treatment using a chest drain in the 5th intercostal space, mid-axillary line and treatment according to ALS or ATLS protocols. ATOMFC = A = airway obstruction, T = tension pneumothorax, O = open pneumothorax, M = massive haemothorax, F = flail chest, C = cardiac tamponade.

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