Health care providers sometimes write emergency action plans that conflict with their current school district and the American Academy of Asthma, Allergy and Immunology guidelines. This creates a challenge for school nurses and an increased risk of anaphylaxis for the patient. Recent studies raise concerns of undertreatment of severe reactions with epinephrine (Boyce et al., 2010; Carlisle et al., 2010; Fleischer et al., 2012; Nowak-Wegrzyn, 2012b). School nurses must find a middle ground between health care providers and parents.