Understanding Asthma in Schools:

What Every School Nurse Needs to Know

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Asthma is one of the most common chronic conditions in children, making it a significant health concern in the school setting. As school nurses, it’s essential to understand the basics of asthma, how it affects students, and how to manage it in the school environment to ensure students are safe and supported throughout their school day.

What is Asthma?

Asthma is a chronic disease that affects the airways in the lungs, making them inflamed and narrow, which can make breathing difficult. Asthma symptoms can vary from person to person but typically include:

Wheezing (a whistling sound when breathing)
Shortness of breath
Coughing, especially at night or early in the morning
Chest tightness

Asthma attacks occur when the airways become even more inflamed and narrow, making it harder to breathe. Triggers can include allergens (like pollen or pet dander), irritants (such as smoke or strong odors), physical activity, and even cold air or stress.

Prevalence of Asthma in Schools

Asthma is one of the most common chronic conditions among children in the United States. According to the Centers for Disease Control and Prevention (CDC), about 1 in 12 children has asthma. This means that in many schools, it’s likely that several students will be managing asthma on a daily basis.

Children with asthma may have different levels of severity. Some may only experience occasional symptoms, while others may face frequent asthma attacks that require medication or even emergency medical care. As school nurses, we need to be prepared to manage asthma in both mild and severe cases.

Critical School Tools

When managing asthma in schools, it’s important to understand the distinct roles and differences for the following types of forms / documents!

Asthma Action Plan, Individualized Healthcare Plans (IHPs), and State Policies & School Procedures

Asthma Action Plan (AAP) – An Asthma Action Plan (AAP) is a written, personalized guide created by the student’s healthcare provider, usually their doctor, to manage their asthma. This plan provides clear instructions for both the student and school staff on how to handle asthma symptoms and prevent attacks. It’s designed to help everyone involved know what steps to take during a specific student's asthma episode. There are many free examples available online to help create or update an AAP. A comprehensive Asthma Action Plan typically includes:

Personalized triggers – What sets off the student's asthma, such as dust, pet dander, or cold air.
Symptoms to watch for – How to recognize the early signs of an asthma attack, such as coughing, wheezing, or chest tightness.
Medications – Detailed instructions about daily medications (like inhalers) and emergency medications (such as rescue inhalers).
Emergency actions – Steps to take if the student’s asthma symptoms get worse, including when to call for help or seek medical attention.

Contact information – Emergency contact numbers, including the student’s doctor and parents.

Individualized Healthcare Plan (IHP) – Written by the school nurse, the IHP is a comprehensive plan that outlines the student’s health needs and how nursing staff will meet those needs during the school day. For students with asthma, and IHP would most likely include the nursing assessment, nursing diagnoses, goals, interventions, expected outcomes, and an evaluation area. IHPs should be reevaluated and updates as needed, but at least each school year.
State Policies and School Procedures – When it comes to managing asthma in schools, it’s important to understand the difference between state policies and school procedures—both are essential, but they serve different purposes.

State Policies- State policies are laws or mandates passed by the state legislature. In Illinois, for example, the law 105 ILCS 5/22-30 allows students to carry and self-administer their asthma medication (like an inhaler) at school, as long as the proper documentation is provided by the parent/guardian and the student’s healthcare provider.
These laws are designed to protect students' rights and ensure schools follow standardized safety guidelines across the state. In Illinois, 105 ILCS 5/22-30 requires schools to:
Permit self-carry/self-administration of asthma medication with appropriate written authorization
Ensure staff are informed and trained on the school’s asthma policies
Maintain an asthma emergency response protocol
Request an Asthma Action Plan for each student diagnosed with asthma
School Procedures- School procedures are the step-by-step processes each school or district puts in place to carry out the state policy. They are the way each school or district follows the law, based on their own staff, setup, and available resources. Examples of school-level procedures include:

How inhalers are stored in the nurse’s office (if not self-carried)
When and how staff are trained to recognize and respond to asthma symptoms
Which forms need to be submitted and how often
Protocols for field trips, gym class, or after-school activities

Role of the School Nurse in Managing Asthma

As the primary healthcare provider in the school setting, the school nurse plays a key role in managing asthma. Here’s what school nurses should know and do to ensure that students with asthma receive the best care:

Engage with families and healthcare providers for consistent asthma care
Ensure Asthma Action Plans are up-to-date
Educate school staff
Encourage the proper use of inhalers
Eliminate and monitor environmental triggers
Emergency response preparedness

On the surface (no pun intended) this video is funny, but it's also scary because it perfectly highlights how crucial it is to educate our students on everything from their diagnoses to recognizing symptoms and using medications properly!

Final Thoughts

As a school nurse, you’re on the frontlines of asthma management. By staying proactive, informed about asthma care, and building strong partnerships with families and staff, you can help students with asthma thrive at school.

The key to success is an individualized approach. When you follow a student’s Asthma Action Plan, recognize early warning signs, and respond quickly, you’re not just managing asthma — you’re helping students stay healthy, confident, and ready to learn.

Together, we can make sure that students with asthma are safe, supported, and fully included in every part of school life — from classroom learning to sports and field trips.

Top 10 Asthma Resources for School Nurses & Families

Centers for Disease Control and Prevention (CDC) – Asthma
https://www.cdc.gov/asthma Offers data, management tips, educational materials, and CDC’s National Asthma Control Program resources.
American Lung Association – Asthma
https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma
Provides asthma basics, treatment info, downloadable Asthma Action Plans, and school-focused resources.
National Heart, Lung, and Blood Institute (NHLBI)
https://www.nhlbi.nih.gov/health-topics/asthma Offers in-depth clinical guidelines and educational resources for professionals and families.
Asthma and Allergy Foundation of America (AAFA)
https://www.aafa.org A comprehensive resource for asthma facts, webinars, support groups, and multilingual asthma action plans.
Allergy & Asthma Network
https://www.allergyasthmanetwork.org Focuses on patient education and advocacy; includes school resources, handouts, and inhaler technique videos.
Healthy Schools Campaign – Managing Asthma in Schools
https://healthyschoolscampaign.org Offers school-specific asthma policies, training modules, and action plan development guides.
National Association of School Nurses (NASN)
https://www.nasn.org/nasn-resources/practice-topics/asthma Curated asthma resources for school nurses, including toolkits, webinars, and evidence-based practices.
KidsHealth – Asthma Center
https://kidshealth.org/en/parents/asthma.html Parent-friendly and kid-friendly information, plus printable guides and student asthma support tips.
Global Initiative for Asthma (GINA)
https://ginasthma.org International guidelines for asthma management and prevention; excellent for updated care standards.
Environmental Protection Agency (EPA) – Asthma and Indoor Air Quality
https://www.epa.gov/asthma Offers resources about managing asthma triggers in the school environment and improving air quality.