History of the Star of Life
When you are out and about around Madison County, be it on Route 29 or one of the byways and see one of our ambulances pass by, ever wonder what the symbol that looks like a star is. You see that symbol on the back windows of some of our ambulances and quite possibly on the side of the unit that pass by. In addition, it could be on the roof of the ambulance, visual queue if we are air lifting someone out.
That symbol is the Star of Life…
In 1966, many baby boomers were either going to war in Viet Nam or going away to college. When people spoke of surfing, it meant something having to do with big waves at the shore, not computers and the Internet. Lyndon Johnson and his Great Society were “happening,” and, Emergency Medical Services (EMS) was in its infancy in the United States. The Star of Life is now an easily recognized symbol of EMS. It is seen on the sides of ambulances, on signs directing people to emergency rooms, and on paramedic patches. However, many people, including many EMS people, don’t know the meaning and history of the Star of Life.
On the South Carolina EMS website it was noted that before 1966, it was common for patients to be transported to the hospital in vehicles operated by funeral homes, and few hospitals had doctors trained in emergency medicine (1). In the late ‘60’s, a study by the National Academy of Sciences was published called Accidental Death and Disability: The Neglected Disease of Modern Society. Dr. Ricardo Martinez, Administrator of the National Highway Traffic Safety Administration (NHTSA) stated in a commemorative edition of this Study: “This paper, known as the ‘White Paper’ revolutionized the way we view and manage injured patients in the United States” (inside cover). The paper studied auto accidents and the injuries they cause; however, it also studied the “system,” or lack of an emergency medical care system, that was in place at the time. It documented many deficiencies in emergency care. In NHTSA Leading The Way, the White Paper is cited and NHTSA states that many recommendations were made to improve medical response to injuries. It was time to make a change in America and develop a true emergency medical care system (6).
Carl Post, in his book Omaha Orange – A Popular History of EMS in America, explains how NHTSA, under the Department of Transportation, was tasked with overseeing a program that authorized planning for ambulances and equipment to go in them, after Public Law 89-56 was passed in 1966 (69).
Under the Department of Transportation, Emergency Medical Technician (EMT) standards were perfected, paramedic standards were developed, and vehicles were purchased for EMTs and paramedics to use when responding to calls (80). To easily recognize these emergency care individuals and vehicles, a symbol needed to be designed. It would become known as the “Star of Life.”
Arline Zatz wrote about the history of the Star of Life in an article for the July-August 1992 Rescue-EMS Magazine. In the article she indicated that at first, EMS used a red cross with four bars, which is a trademark of the American Red Cross (ARC) and the International Red Cross (ICRC). EMS organizations in the late ‘60’s and early ‘70’s used it or an orange version called Omaha Orange (1).
Paramedic Mitch Mendler, on the risherambulance web site, indicated that the ARC did not like EMS using the cross and the ARC stated it was a violation of an international treaty, backed up by federal law. The treaty and law states that the red cross in any form cannot be used by anyone not connected with the ICRC. Johnson & Johnson is the only corporation that can do this because it was grand fathered under the federal law. (3).
