Make sure you get solu-cortef injection !! You child does not make enough cortisol for illness, injury or surgery and will die if you do no immediately get more cortisol.  Without the adrenal insufficiency - people make 4 to 10 time more cortisol for illness.  ALWAYS remember that a fever is an emergency and you MUST increase the cortisol (cortef). You must give the school extra pill to TRIPLE the dose if there is a fever; give 100 mg of solu-cortef IM (injection).  Without the extra cortisol there will be adrenal crisis or she will go into shock - blood pressure drops; sugar and salts drop; coma; and heart stops - death.

 Fever 101 degree (f) - Triple the oral dose; 102 or high give 100 mg solucortef injection; IMMEDIATELY!!! if you just gave the morning dose but fever starts at 0930 - immediately increase (don’t wait!!!).  Then repeat every 6 hours for 48 hours and then step down the doses   - double for 24 hours; and then go normal dose.  You may need IV (salts and sugar) or the cortef my IV.

Repeat vomiting (vomits twice) - give the cortef my injection and get IVs for sugar/salt. 

Of course severe injury or surgery - 100 mg of solucortef.

YOU NEED TO MAKE SURE THE SCHOOL KNOW TO ALWAYS HAVE EXTRA CORTEF, FEVER REDUCER; AND IF ON A SCHOOL BUS - THE INJECTION KIT MUST BE ON THE BUS.

Do not believe for a minute - that you can just call 911 or go to the hospital. The hospital will not know what to do. They will wait too long to figure out what to do. The cortef must be give immediately or she will go into shock and die.