mrcem2-2070

A 15 year old female patient is brought to the emergency department after being kicked by a horse multiple times. The patient had recently started work cleaning stables and was kicked several times whilst behind one of the horses. The patients observations are shown below:

Parameter Result
Blood pressure 108/62 mmHg
Pulse rate 124 bpm
Respiration rate 30 rpm
SpO2 95% on air

On examination there is significant bruising to the right anterolateral aspect of the chest wall, the patient is clammy, there is reduced air entry with dull percussion to the right lung base and the trachea is central. What is the likely diagnosis?