The Blue "Star of Life" -- The Emergency Medical Care Symbol
by Arline Zatz

Just as a pharmacists have the motar and pestle and doctors have the caduceus,
Emergency Medical Techinicians have a symbol, its use is encourged both by the American
Medical Association and the Advisory Council within the Department of Health, Education
and Welfare. The symbol applies to all emergency medical goods and services which are
funded under the DOT/EMS program.

We see the "Star of Life" constantly, whether it be on ambulances or uniforms. But, how
many realize what this symbol represents and how it was born? Not too many, judging from
the random survey I conducted after having realized I had no idea myself.

Designed by Leo R. Schwartz, Chief of the EMS Branch, National Highway Traffic Safety
Administration (NHTSA), the "Star of Life" was created after the American National Red
Cross complained in 1973 that they objected to the common use of an Omaha orange cross
on a square background of reflectorized white which clearly imitated the Red Cross symbol.
NHTSA investigated and felt the complaint was justified.

The newly designed, six barred cross, was adapted from the Medical Identification Symbol
of the American Medical Association and was registered as a certification mark on
February 1, 1977 with the Commissioner of Patents and Trade-marks in the name of the
National Highway Traffic Safety and Administration. The trademark will remain in effect for
twenty years from this date.

Each of the bars of the blue "Star of Life" represents the six system function of the EMS, as
illustrated below: The capitol letter "R" enclosed in the circle on the right represents the fact
that the symbol is a "registered" certification.

The snake and staff in the center of the symbol portray the staff Asclepius who, according to
Greek mythology, was the son of Apollo (god of light, truth and prophecy). Supposedly
Asclepius learned the art of healing from the centaur Cheron; but Zeus - king of the gods,
was fearful that because of the Asclepius knowledge, all men might be rendered immortal.
Rather than have this occur, Zeus slew Asclepius with a thunderbolt. Later, Asclepius was
worshipped as a god and people slept in his temples, as it was rumored that he effected
cures of prescribed remedies to the sick during their dreams.

Asclepius was usually shown in a standing position, dressed in a long clock, holding a staff
with a serpent coiled around it. The staff has since come to represent medicine's only
symbol. In the Caduceus, used by physicians and the Military Medical Corp., the staff is
winged and has two serpents intertwined. Even though this does not hold any medical
relevance in origin, it represents the magic wand of the Greek diety, Hermes, messenger of
the gods.

The Bible, in Numbers 21:9, makes reference to a serpent on a staff: "Moses accordingly
made a bronze serpent and mounted it on a pole and whenever anyone who had been bitten
by a serpent looked at the bronze serpent, he recovered.

Who may use the "Star of Life" symbol? NHTSA has exclusive rights to monitor its use
throughout the United States. Its use on emergency medical vehicles certifies that such
vehicles meet the U.S. Department of Transportation standards and certify that the
emergency medical care personnel who use it have been trained to meet these standards.
Its use on road maps and highway signs indicates the location or access to qualified
emergency care services. No other use of the symbol is allowed, except as listed below:

States and Federal agencies which have emergency medical services involvement are
authorized to permit use of the "Star of Life" symbol summarized as follows:

1. As a means of identification for medical equipment and supplies for installation and use
in the Emergency Medical Care Vehicle-Ambulance.

2. To point to the location of qualified medical care services and access to such facilities.

3. For use on shoulder patches worn only by personnel who have satisfactorily completed
DOT training courses or approved equivalents, and for persons who by title and function
administer, directly supervise, or participate in all or part of National, State, or community
EMS programs.

4. On EMS personnel items - badges, plaques, buckles, etc.

5. Books, pamphlets, manuals, reports or other printed material having direct EMS
application.

6. The "Star of Life" symbol may be worn by administrative personnel, project directors and
staff, councils and advisory groups. If shoulder patches are worn, they should be plain blue
"Star of Life" on a white square or round background. The function, identifying letters or
words should be printed on bars and attached across the bottom separately. The edges of
the basic patch and functional bars are to be embroidered.

Special function identification and physical characteristics must be adhered to when
applying the "Star of Life" to personal items, as follows:

a) Administrative and dispatcher personnel must use a silver colored edge, and the staff of
Asclepius should be with a silver colored serpent. These items do not need a white
background.

b) The shoulder patches and other EMS patches may be displayed on uniform pockets and
the symbol can also be placed on collars and headgear.

This article was taken from Rescue-EMS Magazine, July-August 1992

THE STAR OF LIFE

Each of the six "points" of the star represents an aspect of the EMS System.

They are:

Detection
Reporting
Response
On Scene Care
Care In Transit
Transfer to Definitive Care

The staff on the star represents Medicine and Healing.
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