Michelle, Your experiences are along similar lines to a lot of hospital visits that my daughter and I have had. Your comment that "you will get to know your child" really sums up the issue of when to triple dose etc etc. With experience you learn to read the signs and I now find that I am a lot better at gauging whether to use a shot or triple the dose. I believe that perhaps there is no set rule, each child is unique and what might work for one doesn't neccessarily work for another. Certainly when my girl starts to vomit, I now know that in most cases a triple dose will not suffice and I either give her the shot or we go straight to emergency. Unfortunately experience is the best teacher.