Policy 5534.1 – Anaphylaxis

Every allergic reaction has the potential for developing into a life-threatening event known as anaphylaxis. Anaphylaxis is always a medical emergency as students can have the onset of symptoms within minutes, and if untreated, it can lead to collapse and death shortly thereafter.

Anaphylaxis is usually an immediate reaction occurring within seconds or minutes to an hour following exposure to an allergen (food, insect sting, latex, medication). There is no predictable pattern with anaphylaxis. Each subsequent episode may be the same, more severe, or less severe.

For severe allergic reactions, epinephrine is the drug of choice for treatment. Every student with a history of anaphylaxis should have at least one emergency kit in the health office. Some students may have additional kits at school or may carry a kit with them.

Individuals not know to be at risk of anaphylaxis
A student not known to be at risk of anaphylaxis may also display symptoms of severe allergic reaction. In such circumstances, school staff should assess the situation and take action as would be appropriate for any other illness/injury/emergency incidents. This includes calling 911 if anaphylaxis is suspected.

Any authorized school staff or volunteer, or school bus operator validly authorized under state law to operate the school bus, he/she is operating, may use an epinephrine auto-injector to administer epinephrine to any pupil who appears to be experiencing a severe allergic reaction if, as soon as practicable, the school bus operator, employee or volunteer reports the allergic reaction by dialing the telephone number “911” or, in an area in which the telephone number “911” is not available, the telephone number for an emergency medical service provider.

When given intramuscularly (IM) in the outer thigh, the onset of action is quick and peaks within 9 minutes. It must be given as soon as possible to treat and reverse symptoms. Administering epinephrine buys time to get to an emergency room for additional care.

A second EpiPen® may be administered if no improvement in symptoms occurs within 15-20 minutes. When in doubt, administer EpiPen® and immediately call 911. Due to the short duration of action of epinephrine and the high potential that additional emergency treatment will be needed, prompt activation of the local EMS by calling 911 and subsequent transport to a medical facility is imperative. Unfortunately, epinephrine and other treatments for anaphylaxis are not fail-safe; deaths can and do occur despite administration of emergency medications. The only truly effective treatment is absolute avoidance of the allergen.

When a student known to be at risk for anaphylaxis displays initial symptoms, it must be presumed that the student is in need of the assistance outlined in the student’s emergency health plan. Immediate intervention is essential. It will not harm the student if his/her prescribed medication is given even if anaphylaxis is not present.


  • Wisconsin Statutes
    • Sections 118.125 Confidentiality/maintenance of student records
    • 118.29 Medication administration by school personnel; policy/procedure requirements
    • 121.02(1)(g) Emergency nursing services standard
    • 146.81 – 146.83 Confidentiality of patient health care records]
  • PI 8.01(2)(g) Wisconsin Administrative Code Emergency nursing services requirements; medication administration procedures required


  • 5434 Student Alcohol and Other Drug Use
  • 5531 Emergency Care Services

AFFIRMED: August 27, 2013

Rule 5534.1 – Anaphylaxis

  1. Required Written Statements
    1. Copies of all required written directions of a physician and written consent of a parent/guardian pertaining to administration of medication to a student shall be filed in the school nurse’s or principal’s office.
    2. The practitioner providing the direction and prescribing the medication must state in writing, either on the prescription or in a letter, the name of the student, the name of the drug including strength, dosage, time indications, and duration of the prescription; the specific conditions under which he/she should be contacted regarding the condition or reactions of the student receiving the prescription medication. The practitioner must also express a willingness to accept communication from the person dispensing or administering the prescription medication.
  2. Medication Administration
    1. Designated school employees i.e. health/information assistants, principals, secretaries, teachers, counselors, will dispense and administer medication at the elementary and middle school level.
    2. Senior high school students will be allowed to administer their own medication with written parent/guardian permission. Any secondary school student needing prescription medication during school hours must have the prescription on file in the nurse’s office. If a student is unable to administer his/her own medication, a designated school employee will assume this responsibility.
    3. Parents/guardians of students taking medications labeled twice daily shall administer these at home, unless otherwise ordered by a practitioner.
    4. Parents/guardians of students taking medications labeled three times daily shall administer the first and last dosage, unless otherwise ordered by a practitioner – designated personnel shall administer the middle dosage.
    5. Parents/guardians of students taking medications labeled four times daily shall administer the first, third and fourth dosage and the school shall administer the second.
    6. WI School Meds on line training course for school personnel will be provided.
  3. Medication Storage and Recordkeeping
    1. All medication must be supplied in the original container. The label on the bottle must contain the name and telephone number of the pharmacy, the pupil’s identification, name of the practitioner, medication name, number dispensed, strength, dose, route, times or circumstances for medication to be given, special directions for storage or dispensing. Non-prescription medication must be in the original container with the directions on the container including pupil’s name. The prescribed medication shall be kept in a locked cubicle or drawer. Taking the medication shall be supervised by the designated school personnel at the time conforming with the indicated schedule.
    2. Anyone dispensing or administering medication under Board policy and these procedures shall record such action in a log kept in the school nurse’s or school office. This log will contain the recorded time the medication was administered and the initials of the person who was responsible for the administration of the medication.
    3. Any unused medication at the end of the period for which it was prescribed shall be picked up by the parent/guardian after notification to the parent/guardian, or the medication shall be destroyed.
  4. Liability Exemption
    School employees, except health care professionals, shall be immune from civil liability for any acts or omissions in administering medication to students in accordance with Board policy, these procedures and state law requirements unless the act or omission constitutes a high degree of negligence.

    School employees and volunteers, other than health care professionals, who in good faith render emergency care to a student, are immune from civil liability for any of their acts or omissions in rendering such emergency care.