I haven't evenr ead the repies to this yet so I don't know how much help this is, but it looks like we have had the same weekend!! Kyle, my 3 yr old, has had his first case of haivng alot of vomitting. Apparently, this is something that is just going around. Of course, it is more urgent for out kids. He threw up an 11pm and every 15 minutes for about an hour and a half before I called the ped. We had phenergan in the frig and wanted to amke sure i gave him the right amount. I did have the right amount and he told me to stress dose him now, etc. Well, the vomitting continued for another hour and a half before I decided to just take him to the ER. Between heaves, I took his temp and it was 101* and the tylenol came up , too. I gave the ER doctor a letter from my endo that gave a protocol for vomitting...give phenergan rectally, and to give Soulumedrol (another steroid) and an IV of saline, etc. Well, they did that and were planning to have him on that for a few hours and re-evaluate. Meanwhile, bloodwork came back normal and showing mild dehydration. Also, my ped came to the ER and I explained why I decided to just come to the ER (I didn't call to tell him...I just went). He agreed that I did the right thing and that we could not take chances with him. he decided to admit him for under 23 hours of observation. They gave him more phenergan in the IV since the rectal did not stop the vomitting and he pretty much slept and slept. By mid afternoon, he was chipper. WE could have taken him home, but opted to let him spend the night. He had not had a BM yet and this virus has often been accompanied by diarhea. He cam home this morning and if fine and dandy. This was the first time we had this happen and I was so glas we had that protocol sheet. I know doctors ( many, anyway) don't like to consult each other, and I think this letter just laid it all out. As for how long it takes to have a crisis, I spoke with a mom this week who said she dehydrated in a hour once and had to be admitted for that! If a fluke like that can happen to someone without CAH, I don't htink we need to wait to loong for our kids. In hindsight, I can't believe I let him vomit and much as I did. But once I gave him the phenergan, I kept saying...okay, this is the last time he will get sick.....then he'd throw up again. My feeling is, if they can't keep the meds down, and they have fever...they need the shot and tylenol rectally! Don't be scared to just take your child to the ER.