In the United States, school nurses are faced with a dilemma when treating a student/patient. This dilemma results from the conflicting guidelines of emergency treatment from the patient’s health care provider, the school district, and the American Academy of Asthma, Allergy and Immunology. This results in confusion and may increase the risk of anaphylaxis due to the delay in proper treatment. In fact, recent studies show that there is a serious safety concern with this delayed or lack of treatment of severe reactions with epinephrine (Boyce et al., 2010; Carlisle et al., 2010; Fleischer et al., 2012; Nowak-Wegrzyn, 2012b). Thus, school nurses must work together with parents and healthcare providers to ensure the safety of their students.