Just as I was about to finish OPD at 5 PM and goto the Kailashapuram peripheral clinic, I had this patient with breathing difficulty and I realised after examining him that he had fluid around his lungs - probably pus(empyema). I explained that I would take 3 hours to come back and started the treatment and left for the peripheral clinic. I came back at 9 PM and saw the results which confirmed the presence of pus. However the kid also had a low platelet count and deranged bleeding parameters. In my opinion it would be very risky to insert the chest tube here as he could bleed to death. Although the relatives were a little annoyed, they realised it was for the childs good and soon sped off to another better equipped hospital.
Although it seemed uneventful, I wonder how much risks I can take in this hospital especially when I am alone and what I should not try to manage. I guess the next few months will show me and I pray for wisdom in making the right decisions.