Dear Sue-My daughter is in kindergarten now, but she went to preschool at ages 3 and 4.  The school was just minutes away.  I could not have had her in a school 30 min away.  I am lucky to live in a small town with 7 preschools in the area.  Even the farthest one I would consider is 15 min away and I didn't want to do that either.  With illness, my daughter goes down hill fast.  I wanted to be able to get to her right away in an emergency.  I left a medical kit on site, had an emergency letter and info on CAH.  In the event of vomitting, (or fever of 101 or more) the teachers were instructed to first give 3 (5mg) pills Cortef with a little water and call me immediately. I always had a cell phone if I was not at home, and only did errands 5-10 min drive away.  Since I babysit at home, the biggest concern was to get the kids in the car fast enough-and I had some neighbors who would come to the house for me and sit with the kids.  They never needed to call 911.  They were told to call 911 if I did not respond for 30 minutes, and/or they noticed any lethargy or if unconscious (that has never happened).  I did arrange a meeting with the local rescue chief and unit, and they received an in-service on CAH.  I was told to be sure the person calling 911 stated my daughter's name and need for the injection, and an AEMT would be dispatched-that is an EMT able to inject meds.  Several volunteers said they would make sure she would be cared for properly.  Without this info, an EMT might not be able to help the way she needed it.  When in doubt, I kept my daughter home from school.  We never had an incident at school, but I felt we were covered.  Now, in K, there is a school nurse at all times-so she is instructed to inject, then I can follow through.  It is all very unsettling-to transfer that responsibility to another adult to assess and provide what our SW children need!  Just the separation issue alone is enough!  Good luck!  Pamela