http://www.caresfoundation.org/adrenalcrisis.html - print off the emergency letter.

Have extra cortef pills, tylenol, and solu-cortef at the school. Tell them the medications (especially the cortef and tylenol) must be given immediately (within 30 minutes). They must be given to the ambulance driver with instructions to give immediately.  I think that extra cortef is the most important medication to give and not the phenergan suppos. medication. Besides the phenergan suppos. can cause the child to go asleep and that could be a problem because an adrenal crisis could be going on and coma and you wouldn’t know it.  I would not even want the phenergan suppos. at the school or given. It could mask an adrenal crisis (coma and death).

The instructions should be clear - give cortef and  fluids immediately.  Give sports drinks or salty/sugar drink if vomiting/diarrhea.  If vomit/diarrhea one time.... wait 30 minutes and double the cortef. If repeated vomiting/diarrhea (two times) - give the injection. Go to the emergency room for sodium IV fluids (check sugar levels) and find out why the child is ill.  Then treat the illness but first medicate for the adrenal insufficiency.

Make sure that they understand that fever, vomiting, diarrhea, and serious injury can cause DEATH because your child does not produce enough stress hormones for illness. Normal person will make 4 to 10 times more stress hormones but your child can not make the stress hormones and the medications (cortef) MUST BE GIVEN orally or by injection.  Fever 100 to 101 - double the cortef immediately. Over 101 be very careful to avoid adrenal crisis (coma and death).  Give tylenol to reduce the fever.  The fever should reduce within 30 to 45 minutes  - or give the injection. FEVER can cause death.  Solu-cortef is not just for vomiting/diarrhea.

Who will give the 2 or 3pm dose of cortef?  Even if they are not going to give the medications - they need to have them on hand at all times.  Who will provide transportation.  Will you use a school bus? Or will you drop off and pick up? If you use the bus - they need to have the medication on hand too. 

You might have to call the legal aid people at your court house to get legal advice on enforcing the American’s Diability Act.