What would you do?

Short Story: An 18 yo with somewhat suspected tuberculosis pericardial effusion in the ER at 9 pm. We saw a moderate fluid collection on echo when untrained people did it (namely me, who then made the CT surgeon do it too).  A tap was considered, that is sticking a needle into the space between the sac covering his heart and his heart to remove fluid- risky to puncture the heart and/or lungs or infection. I was told by the CT surgeon that I would be the one doing the tap, not to be afraid, and that he would help me. But I said no, thinking it was not safe and not knowing if it was the indicated procedure. Anyways, it is probably the only time in my medical career where I will have the opportunity to do a semi-emergency pericardiocentesis. And I turned it down. And am proud of myself : )

To start, I typed out the entire detailed story, which delves into so much of the hospital culture and patient care, but couldn't bring myself to publish it here. It involves understanding politics, the lack of resources in this particular hospital, and the limitations and stresses placed on the physicians and patients. To do it justice, I'd be happy to sit down with everyone and delve into it all. Just not here.