We respond to all calls with lights and use sirens where appropriate. The only exception would be if dispatch instructs us otherwise (rare).
We transport all calls in the same way. Lights always on, sirens at intersections and overtaking cars. Our "policy" is to drive the speed limit unless it's a priority 1 code, trauma, etc. At red lights we clear each lane of traffic by stopping at each lane we cross and use eye contact to each vehicle, I don't know how standard that policy is in other services.
I was driving a particularly non-emergent patient last week in the normal fashion. On the way home I asked my senior medic if I should have gone with no L&S. He said using L&S lets us get back in service more quickly, and that had not occurred to me. I do agree with that policy. We have only 2 ALS trucks and due to staffing imbalances (years of experience) we may have the most senior medic at the hospital while the junior truck is heading to an "unknown medical" that turns into a code (happened last month).
