robertahttp://www.caresfoundation.org/
click on adrenal crisis and read this page from CARES. You really need to give the day care provider clear instruction about CAH and adrenal crisis. They need to have the medication at the center or home. What if they had a fever. Do you need to have tylenol and/or motrin at the daycare center or home? You need to tell them to give the medication IMMEDIATELY!! Do you have solu-cortef? Does the daycare? Do they know they must triple the cortef if there is a fever? IMMEDIATELY. If there was a serious infection, or injury they must have the injection within 30 minutes. You can’t wait. They must have it with them. Why risk it? Dose at 4pm and 8pm are too close together. That is only 4 hours!! And then 10 or 12 hours from the 8pm to 6am or 8am dose!! Cortef is very short lasting - only 6 to 8 hours in the body. During illness you must give it every 6 hours! The recommended schedule is 7am; 3pm and 11pm. Most doctors recommend that a higher dose be given morning 7am because of the hormonal surge in the early am. If you child is sick - immediately give more cortef. Say you gave it 6am and the baby is sick at 9 am = triple the dose at 9am!! Triple it immediatley. And then repeat it every six hours. Give tylenol or mortrin immediately and make sure the fever is reduced within 30 to 45 minutes. If the child vomits once. Wait 30 minute and double the cortef (immediatley). If there is repeat vomiting - give the solucortef. This is what you need to tell the daycare. Tell them that a fever or vomiting is an emergency!!!
How many CAH children does this doctor see?
Are you thinking the ambulance or the ER can give solucortef in time? You are wrong!!! You need to give the solu-cortef before you go to the hospital. The ambulance will not have it and if they did - they can not give it. They only drive the patient to the hospital and never heard of CAH anyway. Then in the ER - you are dealing with residents and doctors that are not endo specialist. They will have no clue either.
Get the emergency letter. Get the medication to the daycare provider!!