Treatment of severe allergic reactions at schools. A, School personnel responding to severe allergic reactions. Although they were not always available, school nurses responded to severe allergic reactions an overwhelmingly majority of the time. There was no difference between community types. B, Reasons specified for not giving epinephrine for a severe reaction. C, Rural communities reported epinephrine unavailability more often than urban and suburban communities (85.7% vs 42.4% vs 40%, *P = .037).