Asthma At School

Understanding Asthma in Schools:

What Every School Nurse Needs to Know

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Asthma is one of the most common chronic health conditions you'll encounter as a school nurse—and one of the most important to prepare for before the school year begins.

The good news? You don't have to memorize everything. Strong asthma management starts with good systems, updated documentation, staff education, and trusted resources.

Whether you're caring for one student with asthma or twenty, this guide will help you build confidence in supporting students throughout the 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.

Building Your Asthma Management System

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

1. 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. Helpful Tip: Review Asthma Action Plans before the school year begins and anytime changes are made. Becoming familiar with each student's plan before an emergency occurs helps you respond more confidently. 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.
2. 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.  
3. 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

Supporting Students with 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:

✔ Review Asthma Action Plans

✔ Develop nursing care plans

✔ Educate school staff

✔ Monitor environmental triggers

✔ Promote correct inhaler technique

✔ Coordinate with families and providers

✔ Prepare for emergencies 

Learning from an Asthma Expert

One of the best parts of being a school nurse is that there's always something new to learn.

That's why I was excited to invite Dr. Juanita Mora, CEO of the Chicago Allergy Center and National Spokesperson for the American Lung Association, to share her expertise with members of GROUNDS FOR GROWTH™.

Our discussion covers practical topics school nurses face every year, including:

✔ Asthma Action Plans
✔ Common asthma triggers in schools
✔ Rescue inhaler updates
✔ Practical strategies for supporting students with asthma
✔ Live questions from school nurses

👉 Learn more about GROUNDS FOR GROWTH™ and upcoming member resources below. 

Final Thoughts

Every student with asthma deserves to feel safe, included, and ready to learn.

As school nurses, we help make that happen by building strong systems, educating school staff, partnering with families, and preparing for emergencies before they occur.

Preparation builds confidence—and confidence leads to better care.

Beyond the Asthma Action Plan

Ideally, every student with asthma would have an updated Asthma Action Plan on file each school year—but in reality, that doesn’t always happen. When symptoms start to affect a student’s ability to learn, participate fully in class, or join in school activities, an IHP and sometimes even a 504 Plan are the next best way to make sure the right supports are in place.

That's why I created these editable Asthma resources. Whether you need an IHP, 504 Plan, or Teacher Tips, each resource is designed to save time while helping you create clear, student-centered plans that support both health and learning.

Building Your Asthma Toolkit

 

Patient Education Matters

On the surface (no pun intended!), this video is funny—but it also highlights an important lesson for school nurses.

Students need to understand their own health conditions, recognize symptoms, know when and how to use their medications, and feel comfortable asking for help when something doesn't feel right.

Patient education is an important part of what we do every day, and sometimes a little humor is the perfect reminder of why it matters.

Top 10 Asthma Resources for School Nurses & Families

1. 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.

2. 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.

3. 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.

4. 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.

5. Allergy & Asthma Network
   https://www.allergyasthmanetwork.org Focuses on patient education and advocacy; includes school resources, handouts, and inhaler technique videos.

6. Healthy Schools Campaign – Managing Asthma in Schools
   https://healthyschoolscampaign.org Offers school-specific asthma policies, training modules, and action plan development guides.

7. 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.

8. KidsHealth – Asthma Center
   https://kidshealth.org/en/parents/asthma.html Parent-friendly and kid-friendly information, plus printable guides and student asthma support tips.

9. Global Initiative for Asthma (GINA)
   https://ginasthma.org International guidelines for asthma management and prevention; excellent for updated care standards.

10. 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.