Star of Life

Last update: December 18th, 2023

Design origin and meaning

The blue 'Star of Life' symbol was designed for NHTSA (the National Highway Traffic Safety Administration of the United States of America), in response to the need for a uniform symbol representing the emergency medical services system. The six barred cross was adapted from the personal Medical Identification Symbol of the American Medical Association. For EMS (Emergency Medical Services), the six bars represent the six systems functions as indicated.

The blue 'Star of Life' Emergency Medical Care symbol was original enacted by the United States Congress through the Highway Safety Act of 1966 and its approval of the Highway Safety Guideline on EMS, and since then, the Department of Transportation of the United States of America has vigorously pursued the implementation of a comprehensive EMS system nationwide.

Staff of Asclepius (Greek), Aesculapius (Roman)

Asclepius was the Greek god of medicine. In Greek mythology he was the son of Apollo (god of light, truth, and prophecy) and the nymph Coronis. The centaur Chiron taught him the art of healing, but Zeus (the king of gods), afraid that he might render all men immortal, slew him with a thunderbolt. Homer, in the iliad, mentions him only as the skilled or 'peerless physician' and further identifies him as the father of Podaleirus and Machaeon, physicians to the Greeks in the Trojan War. In later times, however, he was honored as a hero and eventually worshipped as a god. The cult of Asclepius began in Thessaly, but spread to many parts of Greece. Since it was supposed that he effected cures or prescribed remedies to the sick in dreams, the practice of sleeping in his temples became common.

Asclepius was frequently represented standing, dressed in a long cloak, with bare breast; his usual attribute was the staff with a serpent coiled around it. The staff is the only true symbol of medicine. The Caduceus with its winged staff and intertwined serpents, used as a medical emblem by the Military Medical Corps and some physicians, is without medical relevance in its origin since it represents the magic wand of Hermes (in Greek mythology a diety; herald and messenger of the gods; gods of roads, commerce, invention, cunning, and theft; patron of traders and rogues; and conductor of the dead to Hades) and Mercury of Roman mythology, often identified with Hermes, who served also as messenger to the other gods and was god of commerce, travel and thievery.

In 293 B.C. because of the plague, the Romans adopted the cult of Aclepius who became known in Roman mythology as Aesculapius.

Use of the 'Star of Life' Symbol

The 'Star of Life' is a certification mark that was issued on February 1, 1977 (Certificate of Registration No. 1,058,022) by the Commissioner of Patents and Trademarks to the National Highway Traffic Safety Administration (NHTSA).

The certification mark is to be used on emergency medical care vehicles to certify that they meet Federal standards; by emergency medical care personnel to certify, based on their training and affiliation with qualified emergency medical care system, that they are authorized to provide emergency medical care; on road maps and highway signs to indicate the location of or access to qualified emergency medical care service; and such other EMS-related uses that the Administrator of NHTSA may authorize. Any other use is prohibited. Unauthorized use shall be reported to the NHTSA Administrator for investigation and legal action as may be required.

In 293 B.C. because of the plague, the Romans adopted the cult of Aclepius who became known in Roman mythology as Aesculapius.

NHTSA authorized the States (as defined in 23 U.S.C. Section 401) and Federal agencies with EMS involvement to permit use of the 'Star of Life' symbol for the following purposes:

  1. To identify emergency medical care vehicles that meet the Federal Specifications for Ambulances-Emergency Care Vehicles (KKK-C-1822 GSA-FSS) or are authorized by a State or Federal agency involved in the provision of emergency medical care.
  2. To indicate the location of and access to qualified emergency medical services.
  3. On patches or other apparel or personal items (such as badges, lapel pins, buckles, name plates, plaques, etc.) worn or used by an individual.
  4. On bracelets or other items of apparel worn by a patient to inform authorized emergency medical care providers to medical conditions or to identify appropriate treatment with regard to that patient, in accordance with programs established by a State or Federal agency involved in the provision of emergency medical care.
  5. On bracelets or other items of apparel worn by a patient to inform authorized emergency medical care providers to medical conditions or to identify appropriate treatment with regard to that patient, in accordance with programs established by a State or Federal agency involved in the provision of emergency medical care.
  6. On training materials that meet or exceed the U.S. Department of Transportation National Standard Curricula or have been approved by a State or Federal agency involved in the provision of emergency medical care.
  7. On materials such as books, pamphlets, letterheads, plans, manuals, reports, and publications that either have direct EMS application or were generated by an EMS organization. An EMS organization is an organization that either is involved in the provision of emergency medical care or represents persons or organizations who are so involved.
  8. To identify medical equipment and supplies intended for use by authorized emergency medical care providers in the provision of emergency medical care.
  9. By entrepreneurs engaged in the production of medical equipment and supplies or the publication of materials described above.

The following restrictions apply to the use of the 'Star of Life':

  1. As a registered certification mark, the 'Star of Life' must always be accompanied by the symbol consisting of a capital letter R surrounded by a circle, i.e. ®. This marking shall appear immediately adjacent to the 'Star of life' on all decals, uniform patches, printed material, plaques, pins, buckles, name plates, etc. Where the item consists solely of the 'Star of Life' and does not have an adjacent surface of surrounding area (e.g. a lapel pin), the ® shall appear on the reverse side of the item.
  2. The specifications below include a sample of the registered blue 'Star of Life' symbol, and identify the color of the symbol and its dimensions (for three sizes). Deviations in size may be made, provided they are proportionate. Other deviations may be made, provided they create the same commercial impression created by the registered mark.
  3. Some manner of demarcation (such as function-identifying words or letters printed on bars and attached across the bottom separately, and edging of different colors) should be used on patches or other apparel or personal items (such as badges, lapel pins, buckles, name plates, plaques, etc.) worn or used by an individual, to distinguish those worn or used by an individual.