Roberta Prestonhttp://www.cc.nih.gov/ccc/patient_education/pepubs/mngadrins.pdf
Print this out and always have it with you!! Give the solu-cortef for a high fever 102 and above. A fever 100 to 101 (and the child is alert - not too sleepy or out of it) give the triple oral amount of cortef. Give immediately. Do not wait for any reason. Do not wait for the next dose of cortef. YOU MUST GIVE IMMEDIATELY. The child does not produce enough cortisol for fever and the cortisol is needed right away - during the fever. Cortisol does not last long in the body. Therefore the dose that you gave at 7am or 3pm or 11 will not be enough or still in the body for the fever. You can not over dose from the triple dose or the injection but if you do not give it - adrenal shock and death. The sodium level drop, sugar in the blood drop, the blood pressure drop, the brain swells, coma, the heart stops - DEATH.
Give tylenol. Give more fluids - not water but pedalyte or salty/sweet. Have the ER personnel check the blood pressure. And check the sodium and sugar levels during the fever. Be safe. This is something not to gamble with - something that is NOT mother's instinct!!! It is a fact that a CAH child will die from a fever. Never let a child sleep with a fever. Set the alarm every four fours and write down the dose of tylenol or motrin for every four hours. The cortef is needed every six hours. EXTRA fluids are needed. An IV is needed for a high fever.
If you can not print the above - email me. Your doctor needs this pamplet. Please print and post in his/her office for all CAH and Addison's people. It can save a life!! Carry it with you always!!