Here are my reasons for triple dosing:

Complaining of nausea.  Reason I give triple dose immediately when Ashley complains of nausea (and in fact will now be giving 25mg -which is in fact five times his normal dose) is that often more at that point more that is given, the more likely some will be ansorbed.  If it stays down a good length of time it may stop the nausea completely even, and other sometimes they may vomit but will have absorbed some in a lot of cases if it has been something like 25 minutes since the dose.   Thus giving the dose again after the first episode vomiting can more or less sort out the lack of cortisol and stop the vomiting dead in a lot of cases.  It is the lack of cortisol that causes the nausea and vomiting.  it’s important to therefore realise that the more you get down before that occurs in the first instance, the less taxing it is on them.  Headache is usually something I double for as that is a symtoms that Ashley has that crops up before nausea. Its seems that triple is not enough to do this for Ashley at the moment.  5 x 5mg tablets seems to knock it on the head if I can get them down him at the nausea stage.  My objective is always to avoid the vomiting if I possibly can or to avoid it being more than once.  Sometimes when they have a tummy bug though this is not as in your control as it is not as simple as getting cotisol is, the virus has to work it’s way out and that takes time. 

If you just suspect they are sick and they have lot’s of other symptoms apart from nausea or temp--i.e. a cold and feeling headachey and miserable, then you could give double dose.  I kind of use the nausea as a gauge as to whether I double or triple though. 

Very High temp:  I do triple the med’s without delay because the temp will not come down until you dose them cortisol at a sufficient amount.  Sometimes trebling the dose, can mean it sorts the problem out in one stress dose alone.  There has been many a time when I have done that and simply not needed to even double the next dose.  He has coped thereafter.