Are you talking with your doctor??? If my daughter (Karen, age 7) had thrown up as much as you describe, she would be in real danger from DEHYDRATION, which makes getting an IV that much harder. Our docs (2) are in beeper contact with all their CAH families all the time. As soon as Karen throws up the first time, I usually call the doctor, just to give him a heads up. We go over our system for getting her past the crisis without a trip to the ER--effective about 50% of the time. We start with a triple dose of liquid cortef, but if she's vomiting we switch to hydrocortisone pill, ground up in applesauce. (Gives her a bigger jolt of cortef without the stomach irritation.) We also immediately use a suppository of trimethobenzamide to curb the vomiting--the magic bullet that makes all the difference. If the cortef is not staying down, or if she still looks "low" rather than perking up, we switch to an IM shot of hydrocortisone injectable (under the doc's guidance). The first time, I put it off for as long as I could (I didn't want to hurt my sweetheart!) but finally I had to--and the change was almost instantaneous. Better color, more energy--so when we got to the ER, she had a lot more stamina for the IV procedures. It's always tempting for me to put off calling the doctor, because things get much more complicated at that point, but my experience (6 episodes / year) is that it's better to stay ahead of the game (early input from the docs & probable ER visit) rather than let the child get "sick enough" to need the ER, which makes treatment more intrusive and tougher on the child. Good luck! laurie