Hey Yall, So question, I'm a brand new paramedic and have been on the streets for 2 months and I had a call today that has bugged me so much and I would like to hear yall thoughts. 29M called 911 for SOB. Pt states he has hx of asthma, covid 3 weeks ago and started feel SOB yesterday and believes it's his asthma attacks as he had in the past. Pt has tried his inhaler with no improvement. Pt is diaphoretic and appears SOB. BP 133/86, HR 110 SPO2 93(room air) End tidal(N/A). Lungs sounds revealed diminished bilateral wheeze. He was then started on a duo neb and pt stated that he feels a little better and SPO2 becomes 100%. While enroute to hospital pt states he is getting worse and becomes more agitated and SOB. He doesn't want a IV but says that he has had issues before and he was given a shot. Terbutiline .25mg subq was given and with no affect, Duo nebs were repeated. Wheb arrived at hospital pt was changed from a yellow to a red stabilization case and pt was intubated. My question is why was he SPO2 didnt reflect his symptoms. Is this a case of a VQ mismatch?