Rationale:  Anaphylaxis is a life-threatening medical emergency.  Anaphylaxis is a severe response resulting in cardiovascular collapse (shock) after ingestion of or injection with an antigen. This reaction usually occurs within 1-5 minutes of exposure to an allergen but could be delayed up to 5 hours. Immediate intervention with epinephrine injection and a 911 call is necessary.  Common potent allergens include:                                                                           

  • Foods such as peanuts, tree nuts, legumes and shellfish

  • Medications

  • Insect venom

  • Latex

  • Pollens or molds

  • Animal fur

  • Chemical irritants

    EMERGENCY PROTOCOL FOR SEVERE ALLERGIC REACTION:                                                           

  1. Summon school nurse if available.  If not, summon designated trained, first responder to implement emergency protocol.

  2. **Only the school nurse or the designated first responders may assess and administer the EpiPen.

  3. Assessment:  Nurse or first responder will assess the person using the following criteria for anaphylactic reaction and                     treat per assessed need.


  • Skin:  warmth, itching, and/or tingling of underarms/groin, flushing, hives

  • Abdominal:  pain, nausea and vomiting, diarrhea

  • Oral/Respiratory:  sneezing, swelling of face (lips, mouth, tongue, throat), lump or tightness in                the throat, hoarseness, difficulty inhaling, shortness of breath, wheezing reaction

  • Cardiovascular:  headache, low blood pressure (shock), lightheadedness, fainting,   loss of consciousness,  rapid heart rate, ventricular fibrillation (no pulse)

  • Mental status:  apprehension, anxiety, restlessness, irritability 

  1. Call 911 when assessment determines need for EpiPen and report need for epinephrine due to anaphylaxis

  2. Administer EpiPen per standing order. (School EpiPen will be kept in the nurse’s office in orange emergency bag)

  3. Determine cause as quickly as possible and remove source if possible.

  4. Monitor vital signs (pulse, respirations, blood pressure etc) and provide emergency treatment if necessary.

  5. Contact parents immediately and physician as soon as possible.

  6. Any individual treated for symptoms with epinephrine at school will be transported to a medical facility.


  • Administer EpiPen Jr. 0.15 mg if less than 66 pounds and give Benadryl 1 teaspoon
  • Administer EpiPen adult dose of 0.30 mg if 66 pounds or greater and give Benadryl
*1 teaspoon for student from kindergarten – grade 4 and 2 teaspoons for student 5th – 12th grade 

The School’s EpiPen is to be used for life-threatening emergencies only and does not replace a child’s own prescribed medication.  Students with known allergy should have an individual health care plan and keep prescribed medication at school

Training:  The School Nurse will be responsible for training the designated first responders regarding the Protocol for treating anaphylaxis and the EpiPen administration.