OK, I am going to try to explain this one more time. I am going to be as clear as possible because I really don’t think that all of you understand what I am talking about. This has absolutely nothing to do with MedicAlert or OnStar (which I happen to think is a fabulous thing - Love it, BUT they are not going to have any authorization to instruct to inject) . I am talking about if and when someone whom, either does not know about your child and his/her condition or by someone who knows, but is not going to give an injection (think about college here folks, or a car accident or as a teen is somewhere where he is not supposed to be and you think he is somewhere else) and that person calls 911. If they know about your child, that at least is a start BUT whether that person knows anything or not, unless they are willing to give that injection (which is NOT always going to be the case) precious time IS going to be wasted. First of all, not many ambulances in this country carry Solu-Cortef as a rule. Most states have Solu-Medrol (which is usually an acceptable equivilent to most endo’s - pedi and adult. Fortunately, we have been instrumental in getting our state to change their formulary, which we had been previously told would NEVER happen. Never say never!). Then, they are going to waste some more precious time trying to stabalize your child, when in fact, you and I both know that they can try all they want, but unless these kids get their injections, they will be almost impossible to stabalize. Now it almost won’t matter if they have on a medical alert or not or have a letter on themselves stating what condition they have and how they should be treated because, EMT’s can NOT give a steroid injection without approval from the chief ER physician first. Nine times out of ten, that is not going to happen either. Most ER docs have absolutely no clue what CAH is or feel that adrenal insufficiency is all that significant. Just reread the many, many posts on this board over the years whom have complained that ER docs look at them like they are crazy. So meantime, while the EMT’s are having great difficulty trying to stabalize they are going to start to get really worried and try to get your kid to the hospital ASAP because all of sudden, they’re thinking, "Gosh, why can’t we stabalize this kid? Lets transport him now! STAT!". Now, I ask , how much time has passed??? Next, they get the kid to the hospital (God willing they are relatively close to a hospital and don’t run into significant traffic) and into the ER and I almost guarantee you that the EMT’s will be slightly besides themselves and in a slight panic, talk to the ER doc and the ER doc is going to assume he/she has everything under control. God knows that unless you are one of the lucky ones who gets an ER doc who has even heard of CAH and accepts that it is life-threatening, you are now going to have to pull out your paper work from your endo and they will now, and probably reluctantly - because ER docs are notorious for not liking be told what to do--place a call to your endo. Then we wait for the response - then all of sudden he and every other doc and pedi nurse in the ER comes running in practically pushing you out of the way, determined to save your child. I know from reading this board for the past six years or so that I am not the only person that has experienced this epiosode. Now....if your child were "red-flagged" not only in your town or county BUT in your whole state and potentially in the United States 911 system, go back to the beginning... that person that places that 911 call and the 911 operator sees an icon next to your childs name..and low and behold it states that he suffers from life-threatening adrenal sufficiency and will most likely require an immedicate injection of solu-cortef and relays that to his dispatch and that is who gets sent on your childs call--an EMT all prepared and ready to inject IMMEDIATELY without tryin to stablaize first and call ahead for approval for an injection that would probably be rejected and without hesitation simply inject and transport the person immediately to the closest ER. What scenario sounds better to all of you???