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History

Originally, many ambulances used an Omaha orange cross on a square background of reflectorized white to designate them as emergency units. This logo was used before national standards for Emergency Medical Personnel or ambulances were established. Designed by Leo R. Schwartz, Chief of the EMS Branch, National Highway Traffic Safety Administration (NHTSA),[1] the Star of Life was created after the American National Red Cross complained in 1973 that the orange cross too closely resembled their logo, the red cross on a white background.[2] The newly designed cross was adapted from the Medical Identification Symbol of the American Medical Association, which was patented by the American Medical Association (AMA) in 1967. The newly designed logo was patented on February 1, 1977 with the Commissioner of Patents and Trade-marks in the name of the National Highway Traffic Safety and Administration. The logo was 'given' to the National Registry of Emergency Medical Technicians (NREMT) for use as the emergency medical technicians (EMS) logo after the patent expired in 1997.[3]

The Snake Emblem

The snake emblem is the Rod of Asclepius, widely used as the symbol of medical care. There are several theories as to it's development, and it is named for one of them. Asclepius was a figure in Greek mythology who possessed healing powers.

Symbolism

The six branches of the star are symbols of the six main tasks executed by rescuers all through the emergency chain:

  • Detection – The first rescuers on the scene, usually untrained civilians or those involved in the incident, observe the scene, understand the problem, identify the dangers to themselves and the others, and take appropriate measures to ensure their safety on the scene (environmental, electricity, chemicals, radiations, etc.).
  • Reporting – The call for professional help is made and dispatch is connected with the victims, providing emergency medical dispatch.
  • Response – The first rescuers provide first aid and immediate care to the extent of their capabilities.
    On scene care – The EMS personnel arrive and provide immediate care to the extent of their capabilities on-scene.
  • Care in Transit – The EMS personnel proceed to transfer the patient to a hospital via an ambulance or helicopter for specialized care. They provide medical care during the transportation.
    Transfer to Definitive care – Appropriate specialized care is provided at the hospital

Common Use

Star of Life was designed/created by a National Highway Traffic Safety Administration (US Gov) employee and is thus in the public domain.

While no agency is tasked solely with enforcing its use as a mark of certification the Star of Life has traditionally been used as a means of identification for medical personnel, equipment and vehicles.

Many ambulance services mark the symbol on their vehicles, and ambulance crew often wear the design as part of their uniform design. It also appears on various medical textbooks as well as on a wide range of merchandise aimed at the ambulance crew market.

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.