We went to the MAGIC convention in July with our salt-losing (then 9 months old). He got sick there with vomiting (approx 10pm at night) and through the night we triple dosed him. By the morning he began to fade. He had had no true fluid intake and I believe this attributed to his "crash". We were trying to feed him pedialyte in a 10ml syringe without much success. Anyway, by 6:30 am his eyes began to look glassy and we rushed him to a hospital in the area. Dr. Sonya Pang assited the ER doc in his care (over the phone). They hydrated him for several hours and gave him IV Solu-Cortef. It took about 3 hours for him to "return" to us. 2nd episode--late August---He had had one 6oz bottle at 6am before going to daycare. At 8:30 am he was fed another bottle. He threw up in his crib and my husband and I were called. My husband rushed over to the daycare to find him almost limp. His eyes were still open but he was crashing. He took him over to his office across the street to call the Endo and to give the Solu-Cortef. My husband thought he would have more time than he did , but we think the reason he went down so fast with one episode of vomiting was that his blood sugar was low due to only one bottle earlier and no breakfast. Plus, he was not well hydrated. We took him to the pediatrician's office after the shot and he threw up again in the office. He began to look very sick so we admitted him directly to the hospital for IV fluids. We are lucky in that at our hospital our pediatrician and our Endo can "directly admit" a child to the pediatric wing and you do not have to go through anyone along the way. We go directly to the floor and his orders are already called in by our docs. The pharmacy can even have his IV ready before we get there. All you CAH parents should ask your docs about this!!! 3rd episode---Sept 30-(the day we closed on our old and new houses) Our son had had diarrhea for 10 days before this. The weekend it was the worse my husband called our Endo to ask about tripling his Cortef dose. The Endo was very short on the phone and said don't do anything. That day he had 9 stools that soiled 5 sets of clothing!! We tripled his dose that one day and gave him pedialtye all day long. PUSH FLUIDS during these times of stress!! The next week (Thursday) we closed on our old house and got a call from daycare that our son had vomited but looked OK. He had vomited after lunch so his blood sugar wasn't bad and he had been well hydrated that morning. We picked him up and I took him to the pediatrician. He said he was OK and he was no where near being dehydrated even though he had diarrhea all those days. Long story a bit shorter. That afternoon on the way to closing #2 he vomited in the car along with more diarrhea. We closed the house and had to spend the night in a hotel. He threw up at 10 pm (including his Cortef). We called the Endo and pediatrician and the Endo said to take him to the pediatric wing. Our son was not crashing at this time but he had no tears when he was screaming and crying. We took him to the hospital and when we took him into the treatment room he was unresponsive. My husband ran to get the nurse and she pounded his chest. She then called a "CODE BLUE". I got the Solu-Cortef out and administered it there. He woke up right afterwards. In hindsight, I would have given the shot before going to the hospital. That was not smart. He was OK after the shot and they began hydrating him. We only stayed overnight. A FEW KEY TIPS: When they are not hydrated well they crash faster. When their blood sugar is low (like in the am before breakfast after fasting for 8-12 hours) they crash faster. NEVER hesitate to use the Solu-Cortef after vomiting if the child can't keep anything down. The oral Cortef is NOT going to be absorbed quick enough when a CAH person crashes.It won't hurt to give the IV Solu-Cortef if you already gave to oral Cortef and you see the child is not responding or is fading. USE THE SHOT!! I know some parents use the shot anytime the child vomits. You will get to know your child. Hope this helps. Anyone who needs more info can email me. My son is 11 1/2 months old.