Is simply what we are told as parents...except if they cannot get hold of us they need to take our places.  If they cannot get med’s down after they are vomited back the first time then no other symptom matter’s in my opinion... they must be given the shot immediately really.  There is no point delaying the inevitable and in fact caught in time you may be able to even save the child becoming very ill.  If your in an area where you are more than an hour away from an hospital this is especially important because that shot only gives you one hour opportunity, so if you likely to be delayed in A &E or ER (which is common) then you really need to give the shot "before" an ambulance turns up.  This is because of the time delays getting there, and after arrival due to possible staff ignorance around CAH and your child’s Doctor not being available for contact.  In the WHOLE of my time as a Mother, I have never once entered the hsopital and had a membder of staff know exactly what to do immediately and we have waited hours.  The Doctor has not always been available.  This is not worth the risk really.  At least when they have had the shot, they are better able to cope with this kind of delay should it happen...who knows what reception your going to get everytime?  No one.  Who knows how ill their child is and how long it would take for them to go into shock...no one.  If they can answer that "precisely" then they can tell me exactly how much risk they are taking giving my child a shot---and the risk if they don’t is much much higher I believe.  What is the sense in us learning these things when our kids spend the majority of their time in school and daycare after a certain age?  It would be like winning the lottery trying to save their lives in that case half the time because sometimes they are at home when taken ill and in that case they get jackpot because we can inject.  However, think about the time they spend out of our care and in waking hours.  I mean CAH may be rare, but there is no excuse for ignaorance of medical staff or ambulance that could be trained to treat when they see a medic alert bracelet and carry cortisol and have doses to administer.  It is pretty straight forwards where doses are concerned.