Like everyone has already said, there are several things to consider that could improve care.  First off, all staff should be trained with basic healthcare skills so when situations like this occur, then staff would know that basic precautions or steps to take to help improve the situation.  Secondly, the office administration should be oriented to know where all the inhalers are kept and the method that they are labeled.  When I went to elementary school, there was one nurse for four schools.  The way they dealt with inhalers was there was a cabinet that clearly labeled and every child who had to take medication on campus had their own little labeled box.  This was an easy, organized system. Third, what was it that this girl was doing that actually worsened her asthma.  Was she running? Was she just sitting outside?  This is important to consider because it may be able to identify a trend of when she might have another attack, allowing staff to be more prepared in the future. Third, maybe the school district should consider having the inhalers be kept in the students actual classroom, under the supervision of the teacher.  The inhaler would be more accessible and each student would know exactly where to find it. Lastly, there needs to be more school nurses.