Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in sitting semi-upright position . Analysis is performed in direct comparison with the next preceding similar chest examination obtained two and a half hours earlier during the same day . During the short examination interval , a new left - sided chest tube has been placed in addition to the existing previously described one . The new line was inserted two rib spaces lower in the lateral chest wall and advanced through the medial mediastinal pleural space , reaching the apical area . This line apparently has been very effective in removing the pneumothorax which now can not be identified with certainty any more on this portable chest examination . Also , the diaphragmatic contour on the left side is now partially visible again and when comparison is made with the previous examination , the at that time existing degree of mediastinal shift towards the right suggesting tension pneumothorax on the left , has restored to normal position . The patient remains intubated with the ETT terminating in the trachea and the position of the left subclavian central venous line is unaltered .
    OUTPUT:
    
Successful placement of second chest tube eliminating previously described tension pneumothorax . No new pulmonary abnormalities are identified . Suggestion of right middle lobe atelectasis and some pleural effusion as before . Also , the multiple left - sided rib fractures are grossly unaltered .