BOSTON (Reuters Health) - Children treated in busy urban emergency departments run the risk of being prescribed the wrong dose of medication, leading, potentially, to severe adverse outcomes, according to a study conducted at one emergency room.

Many mistakes seem to occur when doctors have to calculate proper dosage based on a child's weight.

The findings are from a study conducted at Albany Medical Center in New York and presented Friday at the American Academy of Pediatrics conference.

Dr. Renee E. Rasmus and colleagues reviewed more than 56,000 pediatric drug orders originating from the emergency department over a 48-month period. They found that a total of 176 "clinically significant" pediatric prescribing errors had been made during this time frame. The incidence of detected errors was 3.1 per 1,000 admissions.

This discovery was "surprising, but expected," Rasmus told Reuters Health. "Albany Medical is a busy ER. We have resident doctors and academics writing orders in a very busy environment," she explained.

The most common errors were underdosing (50%) and overdosing (32%) followed by drug allergy, wrong formulation, and wrong drug (roughly 4% each). Of note, according to Rasmus, 33% of errors had the potential to cause "serious" adverse patient outcomes and 6% could have led to "potentially life-threatening" situations. The errors most often involved antibiotics (74%).

"With pediatric patients, you need to prescribe the medication based on weight," Rasmus said. "And while weight was taken into account in the errors detected, for one reason or another, the math was done improperly or the weight was wrong."

She added, "I don't think Albany Medical is unique. I think that every ER that is seeing children that is busy is making these sorts of errors."

Rasmus hopes a "calculation worksheet" she developed for use in the emergency department will help. "The doctor puts in the weight of the child and follows the calculations so there is less room for error," she said. Rasmus is now with Crow/Northern Cheyenne Hospital in Montana.