By Amy Lester, NEWS 9

OKLAHOMA CITY -- Ambulance crews look at several things before they decide to turn on the lights and sirens when taking a patient to the hospital. Even if the lights are off, it can still be an emergency situation.

A trooper paramedic scuffle that has received national attention was sparked because the ambulance was not running its lights when it was pulled over with a patient inside.

In the controversial video, the paramedic explains repeatedly, there's a patient in his ambulance, even though the lights and sirens are off.

That's before the confrontation escalates and the patient's left waiting.

Trooper Daniel Martin did not think there was an emergency since the ambulance had no lights on, according to his lawyer.

"All Trooper Martin can go from that is that this is not an emergency. This patient in the back of the vehicle is not facing any kind of medical emergency," Trooper Martin's attorney Gary James said.

The paramedic, Maurice White, explained on the CBS Early Show why there were no lights or sirens turned on.

"The patient actually had a fainting episode with chest pain, and it's common practice not to run lights and sirens with those type patients. It really exacerbates their situation," White said.

While EMSA does not want to talk about this case, a paramedic said having lights and sirens on is not the norm.

"By far most of the time when we transport patients to the hospital, it is without lights and sirens," EMSA paramedic John Graham said.

That's because there's an increased risk of a crash, or they may panic the patient. The crew flips them on only if the person's in critical condition like suffering from a gunshot wound or something extremely serious.

"When we put them in the back of the ambulance, we tell them, we're going turn on the lights and sirens. We're going to get you to the hospital as fast as we can because they need a procedure or an intervention we can't provide," Graham said.

For EMSA, there's no hard and fast rule. The crews look at each situation and decide what's best for the patient.

More On News9.com