Such situations are considered more of an exception rather than the rule. However, it would be difficult to pass judgement immediately so it's still better to err on the side of safety and just let the unit through. Personally, medyo duda din ako sa mga 'Donated by Mayor [insert name here]' ambulances dahil ginagamit lang as non-emergency service vehicles ang mga ito kadalasan (pambili ng office supplies, pambili ng ulam, etc.). Ambulances from name-brand hospitals and major ambulance companies are more controlled.

The only time my team leader deployed an ambulance on a code 3 (lights and sirens) run was when we took a patient home somewhere in Marikina. The patient had a new mechanical ventilator by his bedside. Unfortunately, we were having trouble with the ventilator [patient could not breathe when hooked up to it]. Me and the nurse could not leave the patient alone and the respiratory technologist who delivered and set-up the mech vent was in a hospital in Quezon City. So our EMT/driver went to Q.C. to pick up the RT.

There are also instances when the ambulance still has to pick up the doctor. Though these runs are considered more as urgencies rather than full on emergencies. Example would be an aircraft arriving with a patient on board. Dispatch notifies us that a patient is arriving and gives the time of arrival. Sometimes, there is no doctor on duty at the office and the ambulance still has to pick him up from wherever he is (e.g. mall, clinic, another hospital). The travel time to pick up the medical team and travel to the airport is correlated with the touch down time of the aircraft. Sometimes, the margins are too slim and running with the lights and sirens is the only way to give a good margin (ambulance has to be there before aircraft lands).