I have carried an inhaler for the kind of outing that would include a small daypack if taking place on land.

Like swim-commute to and from work (one of my dumber yet somehow still ongoing ideas). And swim-adventure, ie swim across a lake, take a hike, swim back across a lake. I take one of those fluorescent buoys (for boat visibility) with a pouch for t-shirt, sandals, phone, inhaler, etc.

First, regarding access to an inhaler in the water, I can tell you that a wet inhaler still works, shake out the water, shake it again, use it.

Luckily, I am a very good responder to modern asthma meds. I don't carry anything in a competitive event. But in the olden days, when we only had theophylline and ?alupent?, wow, I suffered and frankly had a few near death experiences. Back then, I experimented with several methods for carrying an inhaler while swimming. What I remember working was modifying the plastic case to accept a velcro strap that I secured around my ankle.

Second, if you have, say, unpredictable exercise induced asthma not currently controlled well enough to ensure a trouble-free swim, then I recommend ...

--reassess your controller meds, consider talking to your doctor about options including LABA long acting beta agonist ie formoterol

--reassess your warm up, ie jog before the race, use albuterol inhaler as necessary, induce a refractory period

Here is a WADA link for asthma TUE if you need to have a conversation with your doctor.

https://www.wada-ama.org/...ma#resource-download