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What happens when a child has an asthma attack while at school? If they’re lucky, they have asthma rescue medication at school that they can use. Unfortunately, many students do not. For these unlucky students, an asthma attack often means making a trip to the hospital or going home.

Why don’t all students who need it have this medication at school? Sometimes they do not have a prescription for it. Other times the problem is money: their parents cannot afford to buy the medicine.

Getting a state law passed

A few years ago, the Asthma and Allergy Foundation of America, St. Louis Chapter (AAFA-STL) formed a Public Policy Committee. This committee advocates for things that can help people who have asthma. The first thing they tackled was this problem of access to asthma medications at school.

“We approached our state legislators about the issue,” explains AAFA-STL Executive Director Joy Krieger. “We wanted school nurses to be able to keep asthma rescue medication on hand for any child who needed it.”

“We knew that Missouri already had a similar law for epinephrine,” adds Reagan Nelson, Program Director at AAFA-STL. “This is the emergency medication for food allergy reactions. But we were shocked to learn that there was nothing like this for asthma.”

With this goal in mind, the committee got to work. They met with a legislator who was willing to help support the cause. They testified at committee meetings, lobbied, passed out fliers and more. It was a group effort, and it worked.

In 2012, Missouri House Bill 1188 was passed. This law allows Missouri schools to keep a stock supply of asthma rescue medicine on hand. Trained school employees can administer this medicine to any student who needs it.

This law was the first of its kind in the U.S. 

Creating a program to get asthma rescue medicines in schools

Before the law passed, AAFA-STL started preparing to help schools put it in place.

Through one of their other programs, AAFA-STL had an established relationship with a partner pharmacy. “We approached this pharmacy,” says Krieger. “We asked if they would provide free rescue medication to all the schools we work with, if the law passed. They said yes, and our RESCUE® Program was born. The pharmacy never imagined we would get the law passed in just five months! And they have come through. They provide free rescue medication for all the schools in the program.”

AAFA-STL calls this program the RESCUE Program. RESCUE stands for Resources for Every School Confronting Unexpected Emergencies. The program supports schools that have students who come from low-income families. RESCUE provides school nurses with free nebulizers and the rescue medication that goes into them. A nebulizer is a machine with tubing that takes liquid medicine and turns it into a mist that you inhale. Nebulizers are an option for anyone who has difficulty using an asthma inhaler. 

Besides the support from the pharmacy, other funding comes from donations and grants.

The RESCUE Program is making a big difference for kids

The RESCUE Program invests an average of just $80 per school. It has already helped thousands of students. “The nebulizer medications only cost $4 per box of 24 ampules,” Krieger says. “That’s the price at Walmart. So this is a very doable thing for other groups to implement, too.”

During the 2013-2014 school year, 105 schools participated in the program. Of these, 103 provided AAFA-STL with records of the outcomes. These 103 schools used the free equipment and medicine 1,357 times. In 86% of cases, the student was then able to return to class. Students were sent home 11% of the time. Students had to be taken to the hospital for more advanced treatment 1% of the time.

By the 2014-2015 school year, the program expanded to 207 schools. Of these, 126 provided records of the outcomes. At these 126 schools the supplies were used 1,720 times, with similar results as the previous year.

Medicine was usually used for emergencies or for pre-treatment before exercise. Medicine was also given to children experiencing an asthma flare up. The equipment provides the nurse the ability to monitor the child at school and receive his/her medicine.

Laws and programs like this help kids stay in school learning

“The RESCUE Program is priceless!” says one of the school nurses participating in the program. “Emergencies happen. Just yesterday one of our students who usually carries her own inhaler left it at home. Then she had an asthma attack during physical education class. I was able to give her the medication that she needed. Without RESCUE I would have had to call 911 and pray they got here on time. RESCUE saved the student. Plus, it prevented an emergency room visit and parents losing work time.”

Photo provided by Hixson Middle School, Webster Groves School District. 

Does your state allow stock albuterol in schools? Go to and see where your state stands on this issue.

For information about the Rescue® Program, contact AAFA-St. Louis at or 314.645.2422.

For a toolkit on how to manage asthma in schools, visit SAMPROTM was developed by the American Academy of Allergy Asthma & Immunology with AAFA and other partners.

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