Star of Life

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The Star of Life represents emergency medical services such as ambulances.
Generic Emergency Medical Service flag commonly seen around the US

The Star of Life is a blue, six-pointed star, outlined with a white border and usually featuring the Rod of Asclepius in the center. The Star of Life symbol is currently governed by the U.S. National Highway Traffic Safety Administration (NHTSA) under the jurisdiction of the United States Department of Transportation (DOT). It is now a recognized symbol of Emergency Medical Services in multiple countries.


The Star of Life was originally designed by the American Medical Association (AMA) in 1963 as the Universal Medical Identification Symbol. The AMA did not trademark or copyright the symbol.[1] The symbol was promoted by the American Red Cross and rapidly adopted worldwide as an emergency medical symbol.[2][3] In 1970, when the American Medical Association's Committee on Emergency Medical Services formed the National Registry of Emergency Medical Technicians (NREMT),[4][5] the AMA chose the Star of Life as the organization's logo and a symbol to be used to designate nationally certified Emergency Medical Services personnel. In 1973, the NREMT filed for a trademark for the Star of Life logo. The United States Trademark was granted in 1975[6] and remains part of the trademark of the National Registry of EMTs.[7]

Prior to the development of the Star of Life, American ambulances most commonly were designated with a safety orange cross on a square background. In 1973, the American Red Cross complained that the orange cross too closely resembled their logo of a red cross on a white background, the usage of which is restricted by the Geneva Conventions.[8] Dr. Dawson Mills, Chief of the EMS Branch, National Highway Traffic Safety Administration in the United States, asked the National Registry of EMTs for permission to extend the use the Star of Life symbol as the "national identifier for Emergency Medical Services" in the United States.[9][10]

Leo R. Schwartz, Chief of the EMS Branch, National Highway Traffic Safety Administration in the United States, modified the Star of Life by adding the six main tasks of Emergency Medical Services and changing the color to blue. The "blue Star of Life" was recommended for adoption by the United States Department of Health, Education and Welfare on October 25, 1973,[11] and trademarked on February 1, 1977 in the name of the National Highway Traffic Safety and Administration (registration number 1058022).[12]


Six points on the Star of Life

The six branches of the star represent the six main tasks executed by rescuers all through the emergency chain:[13]

  1. 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, radiation, etc.).
  2. Reporting: The call for professional help is made and dispatch is connected with the victims, providing emergency medical dispatch.
  3. Response: The first rescuers provide first aid and immediate care to the extent of their capabilities.
  4. On scene care: The EMS personnel arrive and provide immediate care to the extent of their capabilities on-scene.
  5. 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.
  6. Transfer to definitive care: Appropriate specialized care is provided at the hospital.

Common use[edit]

An ambulance in Lausanne (Switzerland) marked with multiple Stars of Life.

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 crews often wear the design as part of their uniform. It appears on various medical textbooks as well as on a wide range of merchandise aimed at the medic market. In hospitals and other buildings, elevators that are marked with the symbol indicate that the elevator is large enough to hold a stretcher.[14]


Staff of Aesculapius

The snake-and-staff element of the symbol has a Unicode code point called the Staff of Aesculapius and some fonts may show the Star of Life in this position. Unicode has no dedicated code point for the Star of Life (a trademarked symbol).

See also[edit]


  1. ^ Universal Medical Identification Symbol. Am J Dis Child. 1964;107(5):439. doi:10.1001/archpedi.1964.02080060441001
  2. ^ "Association Acts to Promote Medical Identification Symbol". Circulation. 30 (1): 7. 1964. doi:10.1161/01.CIR.30.1.7.
  3. ^ Dukelow, Donald (1966). "Emergency Medical Identification Symbol". School Health. 36 (1): 20–21. doi:10.1111/j.1746-1561.1966.tb05512.x. PMID 5174672.
  4. ^ "Developing Emergency Medical Services" (PDF). American Medical Association. Retrieved 17 February 2020.
  5. ^ "History of the National Registry of EMTs". National Registry of EMTs. Retrieved 17 February 2020.
  6. ^ "USPTO Trademark Search of US Serial #72454410" U.S. Patent and Trademark Office. Retrieved on 17 February 2020.
  7. ^ "USPTO Trademark Search of US Serial #78453390" U.S. Patent and Trademark Office. Retrieved on 17 February 2020.
  8. ^ "Star of Life - The EMS Symbol". South Dakota EMS. Archived from the original on 2007-07-11. Retrieved 2007-06-29.
  9. ^ Prehospital Care Pearls and Pitfalls. People's Medical Publishing House. 2012. ISBN 9781607951711. Retrieved 17 February 2020.
  10. ^ "Department of Transportation and Related Agencies Appropriations for 1977 Hearings Before a Subcommittee of the Committee on Appropriations, House of Representatives, Ninety-fourth Congress, Second Session. Page 224". United States Congress. Retrieved 17 February 2020.
  11. ^ Star of Life Emergency Medical Care Symbol (Report). DOT HS 803 721. United States Department of Transportation, NHTSA. January 1979.
  12. ^ "USPTO Trademark Search of US Serial #73033491" U.S. Patent and Trademark Office. Retrieved on 17 July 2019.
  13. ^ "Star of Life". Retrieved 2007-06-29.
  14. ^ "Articles:Elevator Car Sizes". 2011-07-11. Archived from the original on 2011-07-11. Retrieved 2012-09-25.

External links[edit]