After experiencing the recent death of my 3 year-old daughter due to an adrenal crisis, I can offer, from experience, how our ER trip went with the medical professionals in the ambulance and ER room having the initial knowledge that she had "congenital adrenal hyperplasia", "adrenal hyperplasia" and "adrenal insufficiency" - yes, it was told to them in those 3 different terms and they had her meds/endos name. Apparently, these terms were not enough to tell the ER room what to do. I had given her an IM injection of 50 mg one hour before she arrived in the ER (she appeared to be in a seizure and/or comatose state). What appears to be the first minute she arrived in the ER room, she was immediately given an endotrache to open "a partially block airway with absent gag reflex." Immediately after this endotrache - her heart failed (I believe she went into shock). With her electrolytes off due to dehydration, her heart was unable to be revived admist their efforts. AFTER the endotrache was done (heart now in failure), she was given an IV with 50% Dextrose in it. The hospital records read "as soon as we found out the history of adrenal hyperplasia we gave her 100mg Solu-Medrol, and followed that up with 200 mg of Solu-Cortef." The Solu-Medrol (prednisone)was given at the 14th minute after the endotrache, Solu-Cortef at the 24th minute. So, given our experience, I think that the Medic Alert information at MedicAlert needs to state something to the effect "Critical - IV Solu-Cortef must be administered before the patient undergoes any stressful procedures, the performance of such procedures can result in immediate shock and/or heart failure. Patient is prone to dehydration and heart failure, stabilization of electrolytes must be considered before the performance of any procedures." Our MedicAlert bracelet has written on the back "Adrenal insufficiency, give glucose, hydrocortisone, saline." Maybe the "hydrocortisone" part might best be changed to state "Solu-Cortef." Also, thanks to all who posted messages/emailed me in the June posting of our tradegy. Still so devastating for our family, which includes her surviving salt-wasting twin sister. Anne