The injection of cortef is for emergency use (a fever that is high and vomiting. A child can die without the injection and IV fluids if not given immedicately (within 30 minutes). Give immedicately if the child vomits twice. Don't take a chance. You can over dose but not enought and the child can die. Same thing with a fever. DON'T CHANCE IT!!! Yes double or triple for a mild fever but a HIGH fever you must not wait and you must give the solu-cortef immediately and then every 6 hours and IV fluids. This is very important. I know sadly enough and some others parents. The doctors do not stress this enough or do not know. And my two and 1/2 year old daughter died from adrenal shock because of a high fever, and adrenal shock. The doctor said to just double the cortef and wait (stop calling him... was his words). The other doctor said to wait until morning... in the morning she was in shock and her heart stopped. They revived her but it took 45 minutes. Hospitals do not just have the medications on hand. You must have it and know how to give it before you reach the hospital. But don't wait unitl it is too late - give it immedicately and give it again every 6 hours and the IV fluids are necessary also. I know sadly that just double the cortef is not enough....especially if the CAH is not managed right to start with and is already near crisis. Jessica was on the liquid cortef and her levels were terrible and doctor just said - there was nothing more she could do. I should have got a better doctor for Jessica. If I could only go back in time!! preston@kreative.net