Thank you everyone for your responses.  Abby is still home from school but is feeling much better.  I am a little brain drained because when they’re sick I don’t sleep well.

Things that were not in my post were that we an excellent line of communication with our endo and excellent treatment in the ER.  We view our relationship with him like a marriage.  It’s a team effort and sometimes you disagree but you’re always on the same side.  I called him before we went to the ER.  She was an inbound referral which means when we got there, the orders were written and a room was ready.  Her doc was part of the entire treatment plan (on a beautiful Sunday - no less!)  Things went very smoothly.  The biggest hitch was the medic in training who tried to put Ab’s IV in.  Abby told her which vein worked best.  Those veins look small but work the best.  She tried the obvious big vein which always gets blocked and rolls when she’s dehydrated.  My hubby had to say please try this vein next time, it will work.  It did.  We were never adversarial with them but more she needs help immediately and we can’t teach you to get the IV in.  Plus she cried like crazy!  She never cries for an iv.  Our hearts broke.  She actually thanked them when it was done.  BUT the student, medic instructor and resident were very interested in learning about CAH and why Abby needed to be there.  It was a great lesson for them and I have to say alot of it came from Abby.  She is so articulate.

The confusion about the cortef dosing came at discharge.  We ok’d the discharge.  Our endo said if we were comfortable with her leaving it would be ok.   There was a lapse in communication.  He said as long as she had a fever or needed medicine to reduce a fever, she should be stress dosed.  Beyond that she wouldn’t need cortef until 2 the next day.  I am no endo but I still don’t agree with that.  At the same time, she did come home with a fever.  We knew she was hydrated and left the ER with her vitals and electrolytes doing well.  So we have dosed her accordingly and she is coming back. 

I think there are appropriate times in the ER to get your "mommy bear" on but most of the time, it is about getting your child better and if you can get it in, let the staff know about CAH.

Thanks for all of your responses!

Blessings,

Tonia