A previously well 23-year-old man presented to the Trauma Department of a large urban Level 1 Trauma Centre in South Africa. The patient sustained a stab wound to the back approximately 3 hours prior to hospital admission. On arrival, his vital signs were as follows: heart rate 105 bpm, blood pressure 96/69 mm Hg, Glasgow Coma Scale of 15/15. The primary survey revealed a 6 cm right posterior stab wound at the T9 level, with evidence of haemopneumothorax on eFAST and chest radiograph. The skin wound was closed, and an intercostal chest drain (ICD) was inserted and connected to a Sinapi reservoir bottle. This immediately drained 1300 mL of blood (figure 1). A CT scan of the abdomen was performed and excluded intra-abdominal injury.