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Respiratory distress is a common symptom of patients transported to hospitals by emergency medical services (EMS) personnel. The benefit of advanced life support for such patients has not been established. METHODS The Ontario Prehospital Advanced Life Support (OPALS) Study was a controlled clinical trial that was conducted in 15 cities before and after the implementation of a program to provide advanced life support for patients with out-of-hospital respiratory distress. Paramedics were trained in standard advanced life support, including endotracheal intubation and the administration of intravenous drugs | Advanced Life Support for Out-of-Hospital Respiratory Distress Advanced Life Support for Out-of-Hospital Respiratory Distress Ian G. Stiell M.D. M.Sc. F.R.C.P.C. Daniel W. Spaite M.D. Brian Field M.B.A. E.M.C.A. Lisa P. Nesbitt M.H.A. Doug Munkley M.D. Justin Maloney M.D. F.R.C.P.C. Jon Dreyer M.D. F.R.C.P.C. Lorraine Luinstra Toohey B.Sc.N. M.H.A. Tony Campeau M.A.Ed. Eugene Dagnone M.D. F.R.C.P.C. Marion Lyver M.D. and George A. Wells Ph.D. for the OPALS Study Group abstract From the Department of Emergency Medicine I.G.S. J.M. Department of Epidemiology and Community Medicine G.A.W. Clinical Epidemiology Program L.P.N. Ottawa Health Research Institute University of Ottawa Ottawa the Department of Emergency Medicine University of Arizona Tucson D.W.S. the Department of Emergency Medicine Queens University Kingston ON Canada E.D. Emergency Health Services Ontario Ministry of Health and Long-Term Care Toronto T.C. Niagara Regional Base Hospital Niagara Falls ON Canada D.M. L.L.T. the Division of Emergency Medicine University of Western Ontario London ON Canada J.D. Joseph Brant Memorial Hospital Burlington ON Canada M.L. and Interdev Technologies Toronto B.F. . Investigators in the Ontario Prehospital Advanced Life Support OPALS Study Group are listed in the Appendix. N Engl J Med 2007 356 2156-64. Copyright 2007 Massachusetts Medical Society. background Respiratory distress is a common symptom of patients transported to hospitals by emergency medical services EMS personnel. The benefit of advanced life support for such patients has not been established. methods The Ontario Prehospital Advanced Life Support OPALS Study was a controlled clinical trial that was conducted in 15 cities before and after the implementation of a program to provide advanced life support for patients with out-of-hospital respiratory distress. Paramedics were trained in standard advanced life support including endotracheal intubation and the administration of intravenous drugs. results The .