I understand everyone’s reluctance to give a shot to their child. It is not fun by any means. . . but in the 2 times that we have had to give our 23 month old daughter the shot I was thankful that we had it to give.  Our endo is also 4 hours away - our ped is very attentive . . . during our daughter’s first 6 months she had over 6 urinary tract infections, 1 of which took her to crisis.  The other time that we have used it was when our daughter began to throw up violently and had probably thrown up 10 times before we made it to the hospital - by the time we were finally checked in she was already getting limp in my arms.  We asked the hospital to give us the stress dose but because they were unfamiliar with CAH they were reluctant and after sitting there for another hour I told them that if they didn’t do it then we would - they said "you’re not allowed to dispense your own medication in our facility."  We told them to sue us and gave her the shot - she perked up in about 10 minutes and went from not being able to hold her head up with her eyes rolling back in her head to standing and reaching for her monitors in about 20 minutes.  You only need to see the results of the shot once to never have to question it again.