Allergy Anaphylaxis
School Nursing
Allergy/anaphylaxis
This section includes all forms and resources available for those who care for students who have anaphylactic reactions to allergies.
Anaphylaxis is a chronic condition that affects 5%-10% of the children in the United States. It can be serious and life-threatening, but it can also be controlled. Symptoms of allergies can be mild, severe, or fatal regardless of previous reaction.
There are 8 foods that account for 90% of all food-allergic reactions. These are: milk, eggs, peanuts, tree nuts (walnuts, cashews, etc.), fish, shellfish, soy, and wheat. Other common allergens include insect stings and latex.
Allergy and anaphylaxis emergency action plan (AAEAP)
- What it’s for: Provides clear instructions on how to recognize and respond to an allergic reaction, including steps to manage anaphylaxis.
- Who writes it: The student’s doctor, with input from the school nurse and parent/guardian.
- Note: The AAEAP also includes the medication authorization required for epinephrine or other prescribed medications.
- Distributed to all "need-to-know" staff, including teachers, aides, and other personnel who are responsible for the student’s care.
Individualized healthcare plan (IHP)
- What it covers: Describes how allergy and anaphylaxis care will be managed at school. It is written using the nursing process, which includes assessment, diagnosis, outcome identification, planning, implementation, and evaluation.
- Who writes it: School nurse for the school nurse
- Important: An IHP must be written for delegation to occur.
Medication authorization form: A form required before medication can be stored, administered, or carried by a student. This form must be submitted to the school every year and must be signed by a parent and healthcare provider. The current AAEP includes the medication authorization within the document.
Utah allergy and anaphylaxis guidelines 2024
Utah standards of care: Allergy and anaphylaxis management in the school setting
Epinephrine treatment infographic- Allergy & Asthma Network
NASN Allergy and anaphylaxis toolkit (Membership required)
Food Allergy Research & Education (FARE)
Anyone who will be involved in treating a student who has an allergic reaction needs to complete the online anaphylaxis training first. Bring the certificate of completion to the school nurse for hands on epinephrine administration competency check off.
Department approved education programs to train:
Epinephrine administration videos
- EpiPen training video (Mylan)
- Auvi-Q training video (Kaleo)
- Teva training video (Mylan)
- neffy® nasal epinephrine training video 33-66lbs (adult giving to child)
- neffy® nasal epinephrine training video- adolescent (student self administering)
- neffy® action plan- optional paperwork to give school staff for students using neffy®
- Instructions for use neffy® pdf
- neffy® pro resources- including powerpoint slides for teaching
Standing order for stock epinephrine
As of August 2024, stock epinephrine can be obtained through a standing order. The details of the standing order are still being finalized. If your school does not have a medical provider to complete the prescription, please contact Sami Bushnell at samanthabushnell@utah.gov for assistance with the process.
Stock epinephrine request information
To obtain stock epinephrine, please provide the following details:
-
School name and address
Include the full name of the school and its mailing address. -
Preferred source for epinephrine auto-injectors
Indicate which program or source you would like to use:- Local pharmacy (out-of-pocket cost may apply).
- EpiPen4Schools free program: Provides up to 4 free EpiPens per school. Visit www.epipen4schools.com for more information.
-
Quantity needed
Specify the number of epinephrine auto-injectors your school requires. -
Type of epinephrine product needed
- EpiPen: For individuals approximately 66 pounds and greater.
- EpiPen Jr.: For individuals 33 to 66 pounds.
Please ensure all information is accurate to expedite the process.
Stock epinephrine
Utah law 26B-4-406 (5(a) requires all schools (primary or secondary, public, and private) to stock at least 1 emergency epinephrine auto-injector for use in a “person exhibiting potentially life-threatening symptoms of anaphylaxis.”
Storage of stock epinephrine
Stock epinephrine auto-injectors must be stored in a secure but easily accessible location that remains unlocked. The location should be known to the school nurse and all designated school staff who are authorized to administer the medication in the nurse’s absence.
Free stock epinephrine programs
Epipen4schools
A free program that provides up to 4 free EpiPens for each school. More information can be found at https://www.epipen4schools.com/
Note: There are two auto-injectors in each EPIPEN 2-PAK or EPIPEN JR 2-PAK
EPIPEN JR Auto-Injector to deliver 0.15 mg of epinephrine injection for individuals 33 to 66 pounds
EPIPEN Auto-Injector to deliver 0.3 mg of epinephrine injection for individuals approximately 66 pounds and greater
neffyinSchools
Unfortunately, Utah schools are unable to participate in the neffyinSchools program due to the stock epinephrine requirements outlined in 2025 HB333. However, students may bring their own neffy as a personal epinephrine device. Schools should still include neffy administration in their staff training to ensure proper use in an emergency.