Just as pharmacists have the mortar and pestle and doctors have the caduceus, Emergency Medical Technicians have a symbol, its use is encouraged 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 Trademarks 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 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 snake and staff in the center of the symbol portray the staff of 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 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 cloak, 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 Corps, 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.