The Star of Life is a symbol used to identify

emergency medical services Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...

. It features a

blue Blue is one of the three primary colours in the RYB colour model (traditional colour theory), as well as in the RGB (additive) colour model. It lies between violet and cyan on the spectrum of visible light. The eye perceives blue when ...

six-pointed

star A star is an astronomical object comprising a luminous spheroid of plasma (physics), plasma held together by its gravity. The List of nearest stars and brown dwarfs, nearest star to Earth is the Sun. Many other stars are visible to the naked ...

outlined by a white border. The middle contains a

Rod of Asclepius In Greek mythology, the Rod of Asclepius (⚕; grc, Ράβδος του Ασκληπιού, , sometimes also spelled Asklepios), also known as the Staff of Aesculapius and as the asklepian, is a serpent-entwined rod wielded by the Greek god ...

– an ancient symbol of medicine. The Star of Life can be found on ambulances, medical personnel uniforms, and other objects associated with emergency medicine or first aid. Elevators marked with the symbol indicate the lift is large enough to hold a stretcher. Medical bracelets sometimes use the symbol to indicate one has a medical condition that emergency services should be aware of. The Star of Life is widely used around the world, but like many international symbols, it has not been adopted everywhere. Its use is restricted to authorized personnel in some countries.

History

The Star of Life originated in the United States. Previously, ambulances in the country commonly displayed a

safety orange Safety orange (also known as blaze orange, vivid orange, OSHA orange, hunter orange, or Caltrans orange) is a hue. Safety orange is used to set objects apart from their surroundings, particularly in complementary contrast to the azure color ...

-colored cross on a square background. This was only a slight variation from the red

Greek cross The Christian cross, with or without a figure of Christ included, is the main religious symbol of Christianity. A cross with a figure of Christ affixed to it is termed a ''crucifix'' and the figure is often referred to as the ''corpus'' (La ...

(✚) used by the

International Red Cross and Red Crescent Movement The International Red Cross and Red Crescent Movement is a humanitarian movement with approximately 97 million volunteers, members and staff worldwide. It was founded to protect human life and health, to ensure respect for all human beings, and ...

. In 1963, the

American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's sta ...

(AMA) designed the Star of Life as a "universal" symbol for medical identification. The AMA did not trademark or copyright the symbol, stating it was being "freely offered" to manufacturers, and also was for use on cards carried by persons with a medical condition. By way of a 1964 resolution, it was adopted by the World Medical Association "as the universal emergency medical information symbol" The Star of Life was promoted by the

American Red Cross The American Red Cross (ARC), also known as the American National Red Cross, is a non-profit humanitarian organization that provides emergency assistance, disaster relief, and disaster preparedness education in the United States. It is the des ...

and rapidly adopted worldwide. In 1970, when the American Medical Association's Committee on Emergency Medical Services formed the

National Registry of Emergency Medical Technicians The National Registry of Emergency Medical Technicians is a US certification agency covering prehospital medical providers. History The NREMT was established in 1970 in response to a recommendation from President Lyndon Johnson's Committee on ...

(NREMT), the AMA chose the Star of Life to designate nationally certified Emergency Medical Services personnel. In 1973, the NREMT filed for a trademark for the Star of Life logo, under the category of a collective membership mark. This version featured a Star of Life enveloped by a circle. NREMT's trademark was granted in 1975, but "was not renewed and therefore has expired." NREMT subsequently registered a

service mark A service mark or servicemark is a trademark used in the United States and several other countries to identify a service rather than a product. When a service mark is federally registered, the standard registration symbol ® or "Reg U.S ...

featuring a Star of Life and the words "NATIONAL REGISTRY." This logo's trademark remains active. In 1973, the

complained that the traditional 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 upright=1.15, Original document in single pages, 1864 The Geneva Conventions are four treaties, and three additional protocols, that establish international legal standards for humanitarian treatment in war. The singular term ''Geneva Conv ...

. Dr. Dawson Mills, Chief of the EMS Branch,

National Highway Traffic Safety Administration The National Highway Traffic Safety Administration (NHTSA ) is an agency of the U.S. federal government, part of the Department of Transportation. It describes its mission as "Save lives, prevent injuries, reduce vehicle-related crashes" relat ...

in the United States, asked the National Registry of EMTs for permission to use the star as the "national identifier for Emergency Medical Services" in the United States," and in 1977 reported to Congress that it had become the national standard. Leo R. Schwartz, Chief of the EMS Branch,

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, and was registered as a

certification mark A certification mark (or conformity mark) on a commercial product indicates the existence of an accepted product standard or regulation and a claim that the manufacturer has verified compliance with those standards or regulations. The specifi ...

on February 1, 1977 in the name of the National Highway Traffic Safety Administration. Both NREMT's version and the US government's modification omit the white outline around the edge common on many of today's ambulances. The US government's registration lists uses of the Star of Life, including "emergency medical care" and "emergency medical care vehicles." The US government's registration does not list any international classes of trademark. Federal standards dictate requirements ambulances in the US must satisfy in order to display the Star of Life. The federal government has given states additional authority to manage the symbol. Private ambulance operators like AMR have trademarked logos featuring an embedded Star of Life.

Symbolism

The six branches of the star represent 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, radiation, 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 First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery. It includes initial i ...

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 A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergen ...

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.

Global usage

Asia

Vehicles of the Hong Kong Fire Services display the Star of Life. The symbol is also widely used in mainland China, Japan, the Philippines, and Singapore. It is less common in South Korea, where ambulances display a green cross and green lights.

Central and South America

The Star of Life is used in many Spanish speaking nations, where it is known as . In Argentina,

Sistema de Atención Médica de Emergencia AFK Sistema PAO is a large Russian conglomerate company, founded by Vladimir Yevtushenkov, who was chairman of the corporation's board of directors until 2022. In April, Yevtushenkov's shareholding in Sistema has decreased to 49.2%, and he also s ...

(SAME), the capital district ambulance service, uses a green and slightly rounded version of the Star of Life in their logo. In Brazil, the Star of Life is incorporated into the national emergency service's visual identity standards. Brazil's ABNT Standard NBR 14561 for ambulance design makes direct reference to being based on the American Star of Life vehicle. Ambulances which do not comply with the Brazilian standard are prohibited from displaying the Star of Life or the word “RESGATE” (rescue).

Australia and New Zealand

A few patient transport providers like Ambulance Service Australia use the Star of Life. However, it is far more common to see the

Maltese Cross The Maltese cross is a cross symbol, consisting of four " V" or arrowhead shaped concave quadrilaterals converging at a central vertex at right angles, two tips pointing outward symmetrically. It is a heraldic cross variant which develope ...

in this region.

European Union

European Union ambulance design standard CEN 1789 section A1 ''Recognition and Visibility of Ambulances'' states:

With the exception of Red Cross societies or where the "Star of life" is locally registered, a blue reflective "Star of life" emblem (minimum size 500 mm) together with reflective letters, numerals or a symbol identifying the organization and the vehicle, should be applied to the roof of the ambulance...a blue reflective "Star of life" emblem should lsobe applied to the sides and rear of the ambulance.

In Portugal, the Star of Life is referred to by the Portuguese name . In March 1977, the Portuguese national ambulance service SNS filed a trademark registration on the symbol, which was granted in 1981. The Portuguese national ambulance service continues to hold a trademark registration in the country, which is used to certify that vehicles are "in accordance with INEM standards" and personnel have "proper preparation". It may also be used on maps and road signs "to indicate the location or access to qualified emergency medical care services". Belgian EMTs use blue stars; nurses, doctors, and ambulance drivers wear other colors. In the Netherlands, the Star of Life is widely used. The Dutch government owns a trademark on the symbol, alongside the paint scheme used on emergency vehicles. In Germany, the symbol was registered in 1993 by industry association BKS, a umbrella organization for private rescue services there. In December 2020, another ambulance industry association, DBRD, filed a challenge with the

German Patent and Trade Mark Office The German Patent and Trade Mark Office (german: Deutsches Patent- und Markenamt; abbreviation: DPMA) is the German national patent office, with headquarters in Munich, and offices in Berlin and Jena. In 2006 it employed 2556 people, of which a ...

. The challengers hired a law firm specializing in

intellectual property Intellectual property (IP) is a category of property that includes intangible creations of the human intellect. There are many types of intellectual property, and some countries recognize more than others. The best-known types are patents, co ...

rights to research the symbol's history. This led to allegations the Star of Life had already been in widespread public use since the 1960s, before being registered in Germany (or the US for that matter). The challengers claimed the trademark office seemed to have been not properly informed of these facts, which presumably could have led the original application to have been denied on

public domain The public domain (PD) consists of all the creative work to which no exclusive intellectual property rights apply. Those rights may have expired, been forfeited, expressly waived, or may be inapplicable. Because those rights have expired ...

grounds. The European Union Intellectual Property Office's 2014 rejection of a trademark on a minimally modified Star of Life was also cited. , BKS continues to hold German copyright on the symbol.

Middle East

Most ambulances in Turkey do not use the Star of Life. Ambulances in Iran commonly display the Star of Life. Egyptian Ministry of Health ambulances display the Star of Life on one rear door, and a red crescent on the other. National Ambulances in the United Arab Emirates does not display the Star of Life, instead showing an EKG graphic on the sides and rear. In Saudi Arabia, the Red Crescent Society answers the emergency line, and provides service in vehicles bearing the crescent emblem. In Israel,

Magen David Adom The Magen David Adom ( he, מגן דוד אדום, abbr. MDA, pronounced ''MAH-dah'' per its Hebrew acronym, ) is Israel's national emergency medical, disaster, ambulance and blood bank service. The name means "Red Shield" or "Red Star of Dav ...

displays a red Jewish star, sometimes shown with a Star of Life. The Jewish star is paired with the

red crystal The emblems of the International Red Cross and Red Crescent Movement, under the Geneva Conventions, are to be placed on humanitarian and medical vehicles and buildings, and to be worn by medical personnel and others carrying out humanitarian w ...

in times of conflict. Israel's other ambulance operator,

United Hatzalah United Hatzalah ("united rescue" in Hebrew: איחוד הצלה) is an Israeli free, volunteer-based emergency medical services (EMS) organization throughout Israel with its headquarters based in Jerusalem. Its mission is to provide immediate med ...

, has a logo based on both stars. "The Star of Life is a universal symbol of emergency medical care. The Star of David is our national symbol. Combining these two elements reminds us of the messages that we...focus on." said United Hatzalah's president. In Palestinian controlled areas, the Palestine Red Crescent Society provides ambulance service in vehicles displaying a red crescent, alongside private operators who often display the Star of Life.

India

Indian Automotive Industry Standard AIS-125 is the National Ambulance Code of India. This document is managed jointly by the Automotive Research Association and the Ministry of Road Transport and Highways. It requires ambulances display several distinctive markings including a reflective Battenburg pattern, the word "AMBULANCE", and the emergency telephone number. The standard states "Displayed on the upper half of the left side should be a 'Star of Life' symbol, with a size of 40cm x 40cm... Displayed on the left back window should be a 'Star of Life' symbol, with a size of 85% of the window".

United Kingdom

Some NHS ambulances in the UK display the Star of Life in addition to the local Ambulance Service emblem. These (latter) emblems have a pale gold six-spoked wheel with a Rod of Asclepius in the foreground. A crown and

, a common EMS emblem in

Commonwealth nations The Commonwealth of Nations, simply referred to as the Commonwealth, is a political association of 56 member states, the vast majority of which are former territories of the British Empire. The chief institutions of the organisation are the Co ...

, are included in the design.

Unicode

The snake-and-staff element of the symbol has a

Unicode Unicode, formally The Unicode Standard,The formal version reference is is an information technology standard for the consistent encoding, representation, and handling of text expressed in most of the world's writing systems. The standard, ...

code point In character encoding terminology, a code point, codepoint or code position is a numerical value that maps to a specific character. Code points usually represent a single grapheme—usually a letter, digit, punctuation mark, or whitespace—but ...

called the Staff of Aesculapius. Unicode has no dedicated code point for the Star of Life.

Gallery

References

External links

* Wikibooks:First Aid
Star of Life from EMS

{{DEFAULTSORT:Star Of Life Star symbols First aid Certification marks Emergency medical services Medical symbols Symbols introduced in the 1960s 1963 introductions