Samuel--the boy with tonsillitis. A care study.
Portsmouth is a nine-bedded mixed adult and paediatric general intensive care unit (ICU) There is great controversy about nursing children in adult ICUs but it occurs. The aim in this care study is to show how this problem was approached in one instance and how care could have been improved. Samuel was a 13-month-old boy who presented to his general practitioner (GP) with a 2-day history of feeling unwell, miserable and lethargic. The GP provisionally diagnosed epiglottis and referred him to the paediatric unit at St Mary's Hospital. The diagnosis was later changed to severe tonsillitis. His condition deteriorated over 24 h and he was referred to the intensive care unit (ICU) team, intubated and admitted to the ICU. Betty Neuman's systems model (Aggleton & Chalmers 1989) was used as a basis for Samuel's care. This incorporates the physiological, psychological, socio-cultural, developmental and spiritual aspects of an individual's needs. In Samuel's case this involved care of his family as well as himself. All names have been changed to protect the individuals involved.