School nurses around the United States face a common dilemma, regarding treatment of certain allergic reactions. Health care providers are recommending strict guidelines of emergency action for their patients. These plans, however, conflict with those provided by the current school district and the American Academy of Asthma, Allergy, and Immunology. Such inconsistencies are likely to result in confusion between the health care providers, the school district, and the American Academy of Asthma, Allergy, and Immunology. But the bigger issue is that delaying proper treatment can potentially increase the risk of anaphylaxis. Several studies illustrate how safety concerns have arisen due to such delays or severe lack of treatment of epinephrine reactions (Boyce et al., 2010; Carlisle et al., 2010; Fleischer et al., 2012; Nowak-Wegrzyn, 2012b). To ensure the safety and best possible care of the students, school nurses should work together with the parents and health care providers to formulate the proper guidelines.