My ped endo didn't give me written instructions on how to give the solu-cortef. The nurse showed my husband and he was suppose to show me. So anyway, I don't know if Danny already has posted how to give the injection or it is a site listed or what... But Anne did mail me this wonderful blooklet from PENS - Pediatric Endocrinology Nursing Society... (Dr. Pang from Chicago is one of the reviewing doctor - Magic Foundation) web site : www.pens.org Here is the instructions from the PEN manual (Dr. Pang, University of Chicago - it one of the reviewer). You really need to either print this or order the book - or I can fax it to the school... or whatever!!! Carry it with you in the kit!!! The amount of hydrocrtisone given in the injection depends on the age or size of the child: children newborn to six months old usually require 25mg (equal to 1/2cc on the syringe) children six months to two years usually require 50 mg (equal to 1cc on the syringe) children two years of age or older usually require 100 mg (equal to 2cc on the syringe) When to give the injection - vomits twice is my rule now. . don't try the wait 30 minute thing or you will be VERY sorry. By the way, the newpaper article quoted your doctor says then is an one hour window - WRONG!!! It is only 30 minutes - believe me I know the hard way!! Anyway this manual sites examples and it discusses giving the oral dose for 101 fever ... but nothing if the fever is over 101 (again I know now by the hard way - 102 fever give the injection... my Jessica died from an Adrenal Crisis ... and she had a high fever and all the ped endo repeatly said to do was double the oral dose and that was not enough) Examples: repeat vomiting (more than once) unconsiousness (NOTE: it does not say this in this book clearly not I read in another one of the PEN books if unconsious give 200 mg (and this booklet gives instructions for giving two virals - which is the same as below except you use two virals)... and then at the hosptial they give another 100 mg 2 hours after, and sodium/sugar IV or D5%/NS or 10% dextrose if hypoglycemia.. and then 100 mg after 6 hours - a total of 300 mg). This is for hypekalemic and hyponatremic crisis - lost of salt is hyponatremic...accompanied by hypovolemia (volemia drugs are used). Basically get to the ER and have the ambulance start the IV if they will or the ER folks start it as fast as they can). repeat episodes of diarrhea surgery (add the fever over 102 Farenheit or 39 degrees Celsius) HOW TO GIVE THE INJECTABLE HYDROCORTISONE USING THE A MIX-O-VIAL OR ACT-O-VIAL 1. Wash hands. 2. Assembel equipment 3cc disposable syringe with attached 23 gauge, 1 inch long needle rubbing alcohol cotton ball medication vial Band-aid (optional) 3. Check the expiration date on the bottle. Do not use if outdated. 4. Remove the ouside cap of vial and push down firmly on the rubber stopper. The Mix-O-Vial top must be turned a quater turn before pressing; the Act-O-Vial requires only pressure. (This forces the water in the upper chamber to push the middle rubber disc down into the lower chamber with the powder). 5. Gentle rotate the vial so the water and powder mix completely and appear clear; not cloudly or clumpy. 6. Wash the outside rubbe stopper on top of thevial with alcohol. 7. Put air into the syringe by pulling back to 2.5 cc (you are going to use 2cc or all of the 100 mg vial) 8. Holding the syringe like a pencil, insert the needle throught the bullseye of the rubber stopper; push the plunger down to force air into the vial. 9. Turn the vial upside down and pull the plnger back to 2.5 cc; drawing the medication into the syringe. KEEP THE NEEDLE TIP BELWO THE SURFACE OF THE LIQUID TO PREVENT AIR FROM ENTERING THE SYRINGE. 10. Check for air bubbles in the syringe; tap to help thm surface; push plunger up to force air back into the vial. 11. Remove the needle form vial. 12. Replace the neddle cover until you have the child ready to receive the injection. 13. Get assistnace holing an uncopperative child. Have the child lie down or sit comfortable. 14. Wipe the middle and top portion of the leg (anterior thigh) with alcohol and let dry. 15. Hold the syringe like a pencil. With your other hand, hold the muscle on top of the leg by opning you hand fully and squeezing the skin. 16. Quickly pierce the skin at a 90 degree angle (straight down) as if you were throwing a dart. Quick, forceful penetration hurting less than "pushing" the needle through the skin. 17. Check to see that the needle is not in a blood vessel by gently lifting the plunger with your thumb or other hand this is called aspirating. Note: if blood does appear inside the syringe, remove the needle without injecting the medicine into the leg and start over. 18. If no blood appears in the syringe, push the plunger down to inject the medicine into the leg. 19. Remove the needle from the leg quickly and release your hand holding the muscle at the same time. 20. Hold dry cotton over the injection site if oozing occurs; apply a Band-Aide. bring the child to the hospital for examination and IV treatment give the second injection may vary - two, four or six hours depending on the degree of shock. (usually 6 hour if the fever is not high) then the doctor will tell how to taper back to a normal dose over overtreatment is better than undertreatment!!!!! Roberta Preston