I haven't read the four pages of posts on this subject, I'll admit, but the subject of running hot comes down to a single simple thing, if we're talking about the situations when accidents happen: EMS drivers are no better than the rank-and-file of American drivers, and we're the worst drivers in the world.
Ohmygod, how dare I say that? Okay, I've been driving racecars for about 30 years and currently drive a heavily modified track Porsche 911 of pretty extreme power. I'm the former Editor of Car and Driver. And as the current Automotive Editor of Conde Nast Traveler, I've driven extensively on every continent but Antarctica for the past 18 or so years.
The only reason we have a pretty good per-100,000-miles fatality rate is that our Interstates and roads, even local roads, are designed and maintained to protect drivers. (You should see the road I just drove on last week in France and Spain, with rows of three-foot-diameter plane trees inches from the road on each side...) If you want to experience a world of drivers who will make you feel like a brand-new sophomore taking driver ed for the first time, go to Germany and get your keister kicked by a nation of drivers who essentially have to go through the equivalent of a U. S. FAA private-pilot solo course to get a simple learner's permit. You will be road kill no matter how many Dale Jr. stickers you have on your pickup.
Anyway, I'm the putative "driving instructor" for our small local volunteer corps, and what I always tell our people during the otherwise-useless NSC CEVO lectures is to subtract 10 mph rather than adding it every time they're using lights and sirens. I have never driven vehicles that handle as badly as our two nearly new modular rigs and one van ambulance, and of course our fly car--a Ford Explorer--is just as big a pig as is every popular SUV. But the box rigs are the worst. It would be interesting to test a standard American modular ambulance against the Sprinter-type ambulances used in Europe and Asia, which I'm sure handle about 20 times as well.
Basically, the question should be, "Why are we allowing inepts to drive over their heads, in porker vehicles never intended to go more than 50, just because they have a siren/yelp/wail/airhorn knob on the console?"
Stephan