Star of Life - The EMS Symbol Just as physicians have the caduceus, emergency medical service personnel have the Star of Life. Use of the Star of Life by EMS personnel is encouraged both by the American Medical Association and the Advisory Council of the Department of Health, Education, and Welfare. The Star of Life applies to all emergency medical products and services funded under the DOT/EMS program. The Star of Life was designed by Leo R. Schwartz, Chief of the EMS Branch of the National Highway Traffic Safety Administration (NHTSA). The Star of Life was created after the American Red Cross complained about the common use of an Omaha orange cross on a square background of reflectorized white which they saw as an imitation of the Red Cross symbol. The NHTSA investigated and felt the complaint was justified.

Adopted from the Medical Identification Symbol of the American Medical Association, the newly designed six-barred cross was registered as a certification mark on February 1, 1977 with the Commissioner of Patents and Trademarks in the name of the National Highway Traffic Safety Administration.

Each of the bars of the blue Star of Life represents the six system functions of emergency medical services, as illustrated below.

	Six Points of the EMS System
	DETECTION
REPORTING     RESPONSE		CARE IN TRANSIT     TRANSFER TO DIFINITIVE CARE
	ON SCENE CARE

The snake and the staff in the center of the Star of Life portray the staff of Asclepius who, according to Greek mythology, was the son of Apollo, the god of light, truth, and prophecy. According to legend, Asclepius learned the art of healing from Cheron, the centaur. But Zeus, king of the gods, was fearful that, with Asclepius' knowledge, men might be rendered immortal. Rather than have this occur, Zeus killed Asclepius with a thunderbolt. Asclepius was worshipped as a god and people slept in his temples, as it was rumored that, in death, he effected cures of prescribed remedies to the sick during their dreams. Eventually, Zeus restored Asclepius to life, making him a god.

Asclepius is usually shown in a standing position, dressed in a long cloak, holding a staff with a serpent coiled around it. The staff has come to represent medicine's most recognized symbol. In the caduceus, used by physicians, the staff is winged, with two serpents intertwined. Although it holds no known medical relevance, it represents the magic wand of the Greek diety, Hermes, messenger of the gods.

In Numbers 21:9, the Bible makes reference to a serpent on a staff. And Moses made a serpent of brass, and put it upon a pole, and it came to pass, that if a serpent had bitten any man, when he beheld the serpent of brass, he lived.

NHTSA has exclusive rights to monitor the use of the Star of Life within the United States. Its use on EMS vehicles certifies that these vehicles meet the U.S. Department of Transportation minimum standards and certify that EMS 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.

Permitted Uses of the Star of Life

As a means of identification for medical equipment and supplies for installation and use in EMS vehicles and ambulances. To point to the location of qualified medical care services and access to such facilities. For use on shoulder patches and insignia worn only by personnel who have satisfactorily completed DOT training courses or approved equivalents, and for persons who by title or function administer, directly supervise, or participate in national, state, or community EMS programs. On EMS personal items, such as badges, plaques, buckles, etc. Books, pamphlets, manuals, reports, or other printed material having direct application to emergency medical services. 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 the 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. The Star of Life trademark, filed with the Commissioner of Patents and Trademarks under the name of the National Highway Safety Administration was to have remained in effect for 20 years from that date, which expired in 1997. This may account for some of the more creative uses of the Star of Life we've seen more recently.

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