Star Of Life
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The Star of Life is a symbol used to identify
emergency medical services Emergency medical services (EMS), also known as ambulance services, pre-hospital care or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to d ...
. It features a
blue Blue is one of the three primary colours in the RYB color model, RYB colour model (traditional colour theory), as well as in the RGB color model, RGB (additive) colour model. It lies between Violet (color), violet and cyan on the optical spe ...
six-pointed star, outlined by a white border. The middle contains a
Rod of Asclepius In Greek mythology, the Rod of Asclepius (⚕; , , , 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 Asclepius, a deity associated with healing ...
– 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 or tags sometimes use the symbol to indicate that the bearer has a medical condition that emergency services may need to know. The Star of Life is widely used around the world, but like many international symbols, it has not been adopted everywhere. In some countries, its use is restricted to authorized personnel.


History

The Star of Life originated in the United States. In 1963, the
American Medical Association The American Medical Association (AMA) is an American professional association and lobbying group of physicians and medical students. This medical association was founded in 1847 and is headquartered in Chicago, Illinois. Membership was 271,660 ...
(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 National Red Cross is a Nonprofit organization, nonprofit Humanitarianism, humanitarian organization that provides emergency assistance, disaster relief, and disaster preparedness education in the United States. Clara Barton founded ...
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 (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 (economics), service rather than a product (business), product. When a service mark is federally registered, the standard ...
featuring a Star of Life and the words "NATIONAL REGISTRY." This logo's trademark remains active. Prior to the use of the Star of Life, ambulances in the United States commonly displayed a safety orange-colored cross on a square background. This was only a slight variation from the inverted Swiss flag () used by the
International Red Cross and Red Crescent Movement The organized International Red Cross and Red Crescent Movement is a Humanitarianism, humanitarian movement with approximately 16million volunteering, volunteers, members, and staff worldwide. It was founded to protect human life and health, to ...
. In 1973, the
American Red Cross The American National Red Cross is a Nonprofit organization, nonprofit Humanitarianism, humanitarian organization that provides emergency assistance, disaster relief, and disaster preparedness education in the United States. Clara Barton founded ...
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, The original document in single pages, 1864 The Geneva Conventions are international humanitarian laws consisting of four treaties and three additional protocols that establish international legal standards for humanitarian t ...
. 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, focused on automobile safety regulations. NHTSA is charged with writing and enforcing Feder ...
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,
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, focused on automobile safety regulations. NHTSA is charged with writing and enforcing Feder ...
in the United States, modified the Star of Life by adding the six main tasks of Emergency Medical Services and changing the color from red (used by the AMA) 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 on a commercial product or service is a registered Mark (sign), mark that enables its owner ("certification body") to certify that the goods or services of a particular provider (who is not the owner of the certification ...
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 a medical emergency, with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is gener ...
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 healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
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

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


West Asia

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 do not display the Star of Life, instead showing an EKG graphic on the sides and rear. In Saudi Arabia, the
Red Crescent Society The organized International Red Cross and Red Crescent Movement is a Humanitarianism, humanitarian movement with approximately 16million volunteering, volunteers, members, and staff worldwide. It was founded to protect human life and health, to ...
answers the emergency line, and provides service in vehicles bearing the red crescent emblem. In Israel,
Magen David Adom The Magen David Adom (, abbr. MDA, pronounced ''MAH-dah'' per its Hebrew acronym, ) is Israel's national emergency medicine, emergency medical, Emergency management, disaster, ambulance and blood bank service. The literal meaning of the name is ...
displays a red Jewish star, sometimes shown with a Star of Life. The Jewish star is paired with the red crystal in times of conflict. Israel's other ambulance operator, United Hatzalah, 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
Palestine Palestine, officially the State of Palestine, is a country in West Asia. Recognized by International recognition of Palestine, 147 of the UN's 193 member states, it encompasses the Israeli-occupied West Bank, including East Jerusalem, and th ...
, 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".


Central and South America

The Star of Life is used in many Spanish speaking nations, where it is known as . In Argentina, the (SAME), the capital district ambulance service, uses a green and slightly rounded version of the Star of Life in their logo. In
Brazil Brazil, officially the Federative Republic of Brazil, is the largest country in South America. It is the world's List of countries and dependencies by area, fifth-largest country by area and the List of countries and dependencies by population ...
, the Star of Life is known by its Portuguese name ''Estrela da Vida''. A red Star of Life is incorporated into the national emergency service's visual identity standards. Brazil's
ABNT The Brazilian Technical Standards Association (, ABNT) is a private non-profit organization and the normative body which is responsible for technical standards in Brazil, and intends to promote technological development in the country. Brazilian ...
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.


Europe

The European Union's ambulance design standard CEN 1789 in 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 Portugal, officially the Portuguese Republic, is a country on the Iberian Peninsula in Southwestern Europe. Featuring Cabo da Roca, the westernmost point in continental Europe, Portugal borders Spain to its north and east, with which it share ...
, the Star of Life is referred to by the Portuguese name . In March 1977, the then National Ambulance Service of Portugal (the present INEM, National Medical Emergency Institute) filed a trademark registration on the symbol, which was granted in 1981. The INEM 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 , Terminology of the Low Countries, informally Holland, is a country in Northwestern Europe, with Caribbean Netherlands, overseas territories in the Caribbean. It is the largest of the four constituent countries of the Kingdom of the Nether ...
, the Star of Life is widely used. The Dutch government owns a trademark on the symbol, alongside the paint scheme used on emergency vehicles. After
Latvia Latvia, officially the Republic of Latvia, is a country in the Baltic region of Northern Europe. It is one of the three Baltic states, along with Estonia to the north and Lithuania to the south. It borders Russia to the east and Belarus to t ...
became independent in 1918, ambulance services in the 1920s and 1930s were provided by the Latvian Red Cross and thus displayed the Red Cross symbol. During the Soviet control of Latvia, that symbol continued to be used as a general symbol of medicine. As restoration of independence, the Riga Emergency Medical Service Station called on the government to adopt the Star of Life (, sometimes ''sniegpārsla'' - 'snowflake') and the change was made with effect from 12 January 1995. It is currently used on vehicles, uniforms and medical service buildings. In
Germany Germany, officially the Federal Republic of Germany, is a country in Central Europe. It lies between the Baltic Sea and the North Sea to the north and the Alps to the south. Its sixteen States of Germany, constituent states have a total popu ...
, the symbol was registered in 1993 by industry association BKS, an 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 (; abbreviation: DPMA) is the Germany, German national patent office, with headquarters in Munich, and offices in Berlin and Jena. In 2006 it employed 2556 people, of which about 700 were patent examiners. ...
. 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 exclusive intellectual property rights apply. Those rights may have expired, been forfeited, expressly Waiver, waived, or may be inapplicable. Because no one holds ...
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. In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
, some
NHS The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
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
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 ...
, a common EMS emblem in
Commonwealth nations The Commonwealth of Nations, often referred to as the British Commonwealth or simply the Commonwealth, is an International organization, international association of member states of the Commonwealth of Nations, 56 member states, the vast majo ...
, are included in the design.


Gallery


Unicode

The snake-and-staff element of the symbol has a
Unicode Unicode or ''The Unicode Standard'' or TUS is a character encoding standard maintained by the Unicode Consortium designed to support the use of text in all of the world's writing systems that can be digitized. Version 16.0 defines 154,998 Char ...
code point called the Staff of Aesculapius. Unicode has no dedicated
code point A code point, codepoint or code position is a particular position in a Table (database), table, where the position has been assigned a meaning. The table may be one dimensional (a column), two dimensional (like cells in a spreadsheet), three dime ...
for the Star of Life.


See also

*
First aid First aid is the first and immediate assistance given to any person with a medical emergency, with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is gener ...
*
Emergency medical technician An emergency medical technician (often, more simply, EMT) is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and som ...
* Emblems of the International Red Cross and Red Crescent Movement


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