RE #3
Back when I was still in NY and working on ambulances, we would rarely, if ever, use the siren (aside from a quick tap or two to clear stopped traffic) when we had someone in back unless they were in such bad shape that they were out cold. Besides the fact that it made it nearly impossible for us to talk, if the siren was going and the patient was conscious, they would usually freak, thinking that their condition "must be really bad, because we have the sirens on".
I have no idea what current protocol is.