I agree that the US have way too many way too big trucks but this…
Ambulances and firetrucks in Europe and Asia are smaller than most american pickup trucks.
… is just wrong. I live in Germany and even small villages with only volunteer firefighters have full blown trucks way above 10 tons.
Most fire departments have something like this:
MAN TGM 18.330 Tank with 4,000 litres of water 18 tons total weight
More specialized departments close to industrial facilities, airports can be also much bigger. This one is currently the biggest weighting 52 tons.
They send a firetruck if someone is having a stroke? Isn’t there a dedicated ambulance for such cases? A ladder truck might make sense to get patients out of a big building but other than that that? Or do they have just one single vehicle that they use for all purposes?