Board Policy No. 3420, Anaphylaxis Prevention and Response, directs staff to be informed about life-threatening allergic reactions (anaphylaxis) and how to respond to the resulting medical emergencies, this includes understanding that:

• Anaphylaxis is a life-threatening allergic reaction that may involve systems of the entire body.
• A life-threatening health condition means a condition that will put the child in danger of death during the school day if a medication or treatment order providing authority to a registered nurse and nursing care plan are not in place.
• Anaphylaxis is a medical emergency that requires immediate medical treatment and may require follow-up care by an appropriate health care provider.
• Affected students require planned care and support during the school day and during school sponsored activities.
• Common life-threatening allergens include, but are not limited to, peanuts, tree nuts, fish, dairy, bee or other insect stings, latex, and some medications.
• Avoiding the allergen is the only way to prevent anaphylaxis.
• Any student could potentially have a life-threatening allergic reaction even without a history of such. When epinephrine is administered to treat anaphylaxis, emergency medical services (EMS) should immediately be activated, and the parent/guardian and school nurse should be notified.

For students with a medically diagnosed life-threatening allergy (anaphylaxis), the District will take appropriate steps for the student’s safety, including implementing a nursing care plan developed by the school nurse. The District will utilize the Guidelines for the Care of Students with Anaphylaxis published by the Office of the Superintendent for Public Instruction.

Parent/Guardian (or Emancipated Student) Responsibility

Upon enrolling a student, the parent/guardian will inform the District in writing of the medically diagnosed allergies and risk of anaphylaxis. The District will develop a process to identify students at risk for life-threatening allergies and to report this information to the school nurse. Upon receiving the information, the school nurse will have contact with the parent/guardian to develop a nursing care plan. A nursing care plan will be developed for each student with a medically diagnosed life-threatening allergy. This plan will include emergency management and mitigation strategies to make reasonable efforts to avoid exposure to allergens.

Nursing Care Plan

The school nurse (registered nurse) will develop a written plan that identifies the student’s allergies, symptoms of exposure, practical strategies to minimize the risks, and how to respond in an emergency.

The principal or designee shall arrange for a consultation between the school nurse and parent/guardian prior to the first day of attendance to develop and discuss the nursing care plan. The plan will be developed by the school nurse in collaboration with the parent/guardian, licensed health care provider (LHP), and appropriate school staff. If the nursing care plan includes self-administration of medications, the parent/guardian, student, and staff will comply with Board Policy No. 3419 and Superintendent Procedure 3419SP, Self-Administration of Asthma and Anaphylaxis Medication.

Annually updated and prior to the first day of attendance, the student health file will contain: 1) a current, completed nursing care plan; 2) a written medical order, signed by a LHP; and 3) an adequate and current supply of epinephrine autoinjectors or intranasal medication and other medications if needed. The school will also recommend to the parents/guardians that a medical alert bracelet be worn by the student at all times. The parents/guardians are responsible for notifying the school if the student’s condition changes and for providing the medical treatment order, appropriate epinephrine autoinjectors or nasal spray, and other medications as ordered by the LHP.

The District will exclude from school those students who have a medically diagnosed life-threatening allergy and no medication or treatment order presented to the school to the extent that the District can do so consistent with federal requirements for students with disabilities under the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973, and pursuant to the following due process requirements:

• Written notice to the parents/guardians or persons in loco parentis is delivered in person, by certified mail, or email;
• Notice of the applicable laws, including a copy of the laws and rules;
• The order that the student shall be excluded from school immediately and until medications and a medical order are presented; and
• The student’s and parent’s/guardian’s right to a hearing to challenge the decision.

Communications Plan and Responsibility of School Staff

After the nursing care plan is developed, the school principal or a designee will inform appropriate staff regarding the affected student. The school nurse (registered nurse) will train appropriate staff regarding the affected student and the nursing care plan. The plan will be distributed to appropriate staff and placed in appropriate locations in the District (classroom, office, school bus, lunchroom, near playground, etc.). With the permission of parent/guardian and the student, (if appropriate), other students and parents/guardians may be given information about anaphylaxis to support the student’s safety and control exposure to allergens.

Training

All School Staff Training

Annually, each school principal will provide an in-service training on how to minimize exposure and how to respond to an anaphylaxis emergency. The training will include a review of avoidance strategies, recognition of symptoms, the emergency protocols to respond to an anaphylaxis episode (calling 911/EMS when symptoms of anaphylaxis are first observed), and hands-on training in the use of an epinephrine autoinjector and nasal spray. Training should also include notification that more than one dose may be necessary in a prolonged anaphylaxis event.

Student-Specific Training

Annually, before the start of the school year and/or before the student attends school for the first time, the school nurse will provide student-specific training and additional information to teachers, teacher’s assistants, clerical staff, food service workers, and bus drivers who will have known contact with a student diagnosed with a known allergen and implementing the nursing care plan.

Controlling the Exposure to Allergens

Controlling the exposure to allergens requires the cooperation of parents/guardians, students, the health care community, school employees, and the Board. However, even with the District’s best efforts, staff and parents/guardians need to be aware that it is not possible to achieve a completely allergen-free environment.

Steps to reduce exposure include the following:

• Informing parents/guardians of the presence of a student with life threatening allergies in their child’s classroom and/or school and the measures being taken to protect the affected student.
• Asking parents/guardians to cooperate and limit the allergen in school lunches and snacks or other products.
• Discouraging the sharing of food, utensils, and containers.
• Appropriate cleaning of eating surfaces.
• Taking other precautions such as avoiding the use of party balloons or contact with latex gloves.
• Specifying eating areas and play areas that are lowest risk for the affected student.

The District will also identify high-risk events and areas for students with life-threatening allergies, such as foods and beverages brought to school for seasonal events, school equipment and curricular materials used by large numbers of students (playdough, stuffed toys, science projects, etc.) and implement appropriate accommodations.

During school-sponsored activities, appropriate supervisors, staff, and parents/guardians will be made aware of the identity of the student with life-threatening allergies, the allergens, symptoms and treatment. The lead teacher will ensure that the autoinjector is brought on field trips.

Undesignated Epinephrine 

District Prescription and Standing Order Protocol

The District may maintain a supply of undesignated epinephrine autoinjectors or nasal spray that will be prescribed in the name of the District by an LHP with the authority to prescribe epinephrine. The District prescription is valid for one school year only and will need to be renewed prior to the start of each school year. A standing order and prescription from a LHP may be used for the purposes of maintaining and administering undesignated epinephrine autoinjectors.

Each prescription must be accompanied by a standing order for the administration of school-supplied epinephrine autoinjectors for potentially life-threatening allergic reactions. The standing order protocol should include specific symptoms of anaphylaxis, the dose of medication, and directions to summon emergency medical services (EMS/911) upon observance of symptoms of anaphylaxis. Parent/guardian notification should occur as soon as possible after EMS is notified.

Donation

The District will obtain epinephrine autoinjectors or nasal spray directly from an appropriate practitioner, pharmacist, medical facility, drug manufacturer, or drug wholesaler. All epinephrine must be accompanied by a prescription. 

Storage, Maintenance, Expiration, and Disposal of Medications

School staff will comply with all manufacturer’s instructions as to storage, maintenance, expiration, and disposal of epinephrine. School staff will also comply with Board Policy No. 3416 and Superintendent Procedure 3416SP, Medication at School, and District processes related to safe, secure management of medications. 

Administration

Epinephrine may be used on all school property, including buildings, playgrounds, and school buses. For school-sponsored events and field trips, the school nurse or designated trained school personnel may carry an appropriate supply of school-supplied epinephrine. This does not negate the need to carry the supply of epinephrine devices belonging to students with known anaphylaxis.

In the event a student without a current prescription on file with the school or a student with undiagnosed anaphylaxis experiences an anaphylactic event, the school nurse may utilize the school supply of epinephrine to respond under the standing order protocol.

In the event a student with a current prescription for epinephrine on file at the school experiences an anaphylactic event, the school nurse or designated trained school personnel may use the school supply of epinephrine to respond if the student’s supply is not immediately available.

The District will maintain all practices regarding prescriptions and self-medication for children with existing epinephrine prescriptions and/or a nursing care plan. Parents/guardians of students with identified life-threatening allergies must continue to provide the school with appropriate medication and treatment orders pursuant to RCW 28A.210.320, Life-Threatening Conditions, regardless of whether the District maintains a supply of undesignated epinephrine autoinjectors or nasal spray.

Employee Opt-Out

School employees (except licensed nurses) who have not previously agreed in writing to the use of epinephrine autoinjectors as part of their job description may file a written letter of refusal to administer epinephrine autoinjectors with the District. The employee’s refusal may not serve as grounds for discharge, non-renewal, or other action adversely affecting the employee’s contract status.

No Liability

If the school employee or school nurse who administers epinephrine to a student substantially complies with the student’s prescription (that has been prescribed by a LHP within the scope of the professional’s prescriptive authority) or a statewide standing order and the District’s policy on anaphylaxis prevention and response, the employee, nurse, District, Superintendent, and Board are not liable for any criminal action or civil damages that result from the administration.

Policy Cross References

• 3416 – Medication at School
• 3418 – Response to Student Injury or Illness
• 3419 – Self-Administration of Asthma and Anaphylaxis Medications
• 3420 – Anaphylaxis Prevention and Response

Revisions

• February 24, 2026
• January 21, 2015

Adopted

• December 16, 2011