School nurses in the United States are challenged by the fact that health care providers are writing emergency action plans in the case of anaphylactic reactions “that conflict with their current school district and the American Academy of Asthma, Allergy and Immunology guidelines.” School nurses must work to be in a position where they could administer epinephrine as often as deemed necessary in order to avoid severe risk to the children being treated.  (Wahl et al. 2015, 97).