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Infant hip clinic referral form Vaccination referral form Assessment and management of babies who are accidentally dropped in hospital DGRI NNU Guideline for Management of Cord Blood Gas Results NNU Admission Criteria Antenatal Drugs for NAS Monitoring Neonatal Guidelines
Home | Articles | Neonatal | Assessment and management of babies who are accidentally dropped in hospital

Assessment and management of babies who are accidentally dropped in hospital

Last updated 27th August 2024

The risks of accidentally dropping a baby are well known, particularly when a parent falls asleep while holding a baby; or when a parent or healthcare worker holding the baby slips, trips or falls. Despite healthcare staff routinely using a range of approaches to make handling of babies as safe as possible, and advising new parents on how to safely feed, carry and change their babies, on rare occasions babies are accidentally dropped.

If the baby is an inpatient in hospital the following should be carried out:

  • Notify the Paediatrician or Advanced Neonatal Nurse Practitioner to review the baby’s clinical condition as soon as possible, taking note if the fall was witnessed, which body part made contact with surroundings (paying particular attention to the composition of the surfaces involved) and the height of drop. This should be documented as it is vital to share this information with the person undertaking the review, in order for them to assess the potential impact from the fall accurately.  If there is any visible injury and the incident was NOT witnessed by a healthcare professional, then the West of Scotland Child Protection Guidelines should be adhered to.
  • Where a head injury is suspected the baby will require admission to the Neonatal Unit for monitoring and for neurological observations to be carried out at the following intervals for a minimum of 24 hours:
    • Half hourly for 2 hours
    • Hourly for 4 hours
    • 2 hourly thereafter
  • Monitoring should include assessment of:
    •  pupil size and reactivity
    • limb movements
    • respiratory rate
    • heart rate
    • blood pressure
    • temperature
    • blood oxygen saturation
    • Glasgow Coma Scale (GCS)
  • There should be a low threshold for requesting CT scanning for any of the following:
    • Agitation
    • abnormal movements
    • lethargy
    • vomiting
    • low GCS score (paediatric version of the GCS, include a ‘grimace’ alternative to the verbal score to facilitate scoring in babies).

For more detail on head injury management please refer to:

Overview | Head injury: assessment and early management | Guidance | NICE (May 2023)

  • Arrangements for further review and tests should be made where it is applicable e.g. x-rays, cranial ultrasound scan and surgical opinion should be sought as appropriate. 
  • A detailed discharge summary should be sent to Midwife, GP and Health Visitor. Submit DATIX and complete all relevant documentation.

If the dropped baby is a visitor to the hospital:

  • Refer to Emergency Department for review and assessment. If their clinical condition necessitates it, call for urgent medical review of the baby.
  • Taking note if the fall was witnessed, which body part made contact with surroundings (paying particular attention to the composition of the surfaces involved) and the height of drop. This should be documented as it is vital to share this information with the person undertaking the review, in order for them to assess the potential impact from the fall accurately. 
  • Submit DATIX and complete all relevant documentation.