If I understand correctly, if a hopsital ER is put on bypass, there has to be another facility in the area that is accepting emergency patients. You can call your Pediatrician, the Endocrinologist, call the ER for advice, and some places have ER help telephone systems. A fellow CAH family in your area is also helpful. Are you aware of MAGIC FOUNDATION? There phone number is 1-800-3MAGIC3. They have lists of parents all over the country that you can talk to. We try to monitor our CAH child carefully, we try to "nip" things before she is in Crisis. A stress dose of meds when her temp is 2 degrees over her normal: is she pulling at her ears, cranky, overtired, refusing to eat? You know your child best, how does she act when she/he is starting to get sick, or when she/he is sick?