Game:

Emergency Call Ambulance (1999)

Duration: 8:14

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2

A 1-credit clear of the arcade game Emergency Call Ambulance, played with the SuperModel model 3 emulator. Score: 18,965.

Some notes on the "4th gear trick":
* Supermodel config: Change input type="shiftupdown" to input type="shift4" in Games.xml in the "eca" and "ecau" and "ecaj" sections
* Game config: Hit the Test button (default: 6) then press the Service button (default: 5) to move the cursor to "game assignments" and hit Test (6). Then then move the cursor to "gear lever" and toggle it to 4-speed. Then go to Exit, then to Exit.
* Now you can press 3 to insert an imaginary let's-pretend coin, then push right to select Manual, then press Up.
* Mash 1+A to skip cutscene
* Hold UP to accelerate, and twitch your fingers between R and T to toggle between 4th gear and neutral, to accelerate extra-fast.

Once you know the 4th gear trick, there's not much more to explain. You have a time limit (the patient's health), that ticks down faster if you bump into anything. So drive fast (but slow enough you can still make turns), take shortcuts when you can, and avoid everything. As you might expect, type of collision matters - it's better to knock down a light pole than to have a head-on collision with a van. The ambulance has trouble with tight turns at high speed, so sometimes it's best to hold down to brake, then do the 4th-gear trick if you need to build up speed again.

Like so many games, this is a clear I learned by watching 1CCBBH. His run has some commentary as well as comments on the video that explain some scoring tech: https://www.youtube.com/watch?v=k67dNNTlu0s