If you’re out running errands or driving around town, it’s not uncommon to pull your car over for the flashing lights and sirens of an ambulance whizzing by you. These emergency medical vehicles are crucial to saving lives and getting folks to critical emergency care right away. But have you ever looked closely at an ambulance as it’s flying by? If you have, you may have noticed a blue star on the ambulance. But what does the star symbol mean?

That blue star symbol isn’t random, and in fact, it’s an important part of modern, standard emergency medicine services. Read on to find out what it means and how it became a universal symbol.

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What is the symbol on ambulances called?

The star symbol you see on an ambulance is called the Star of Life. This relatively recent symbol denotes Emergency Medicine Services (EMS) personnel or vehicles. The easily recognizable six-bar design is used throughout the United States and is a standardized way to identify EMS providers and emergency vehicles like ambulances.

What does it symbolize?

The six individual bars of the Star of Life may all look the same, but each symbolizes something different, according to the U.S. Department of Transportation and the National Highway Traffic Safety Administration. Here’s what each one means:

  1. Detection

  2. Reporting

  3. Response

  4. On-scene care

  5. Care in transit

  6. Transfer to definitive care

These points represent the six systems functions of an EMS provider.

But the symbolism doesn’t stop there. Besides the six points, you’ll notice the serpent and staff symbol in the middle of the star—and if you thought it looked like something out of Greek mythology, you wouldn’t be wrong. The serpent and staff within the star symbolize the staff of Asclepius, the Greek god of medicine. According to EMS.gov, the staff itself represents the healing power of medicine, while the serpent represents renewal.

What’s the history of the Star of Life?

back of an ambulanceDouglas Sacha/Getty Images

The Star of Life was actually adapted from a similar medical star: the personal Medical Identification Symbol of the American Medical Association (AMA). The Medical Identification Symbol is a similar six-point star with a staff and serpent, but it also features a hexagonal outline around the star. The AMA introduced the symbol in 1963, with the intention that it could be used on cards or other materials that someone could carry to identify that they had a complex medical issue, such as epilepsy or diabetes. It wasn’t copyrighted or trademarked, and the AMA routinely encouraged its use to the public—so much so that the World Medical Association adopted the symbol for use around the globe by 1964 as the Universal Emergency Medical Identification Symbol. By 1966, U.S. federal organizations like the FBI began referring to the symbol as the Star of Life.

Around the same time, Congress passed the Highway Safety Act of 1966 and approved the Highway Safety Guideline on Emergency Medical Services. Lyndon B. Johnson’s administration wanted to reduce serious crashes and implement highway reform, as well as integrate a uniform EMS system across the country that worked in tandem with Highway Safety. After the Highway Safety Act was passed, Irvin E. Henderson, MD, the chairman of the AMA Commission on Emergency Medical Services, began pushing the Department of Transportation (DOT) to start using the symbol on street signs to identify nearby hospital emergency rooms.

Eventually, the AMA adopted a slightly revised symbol—the modern-day Star of Life design without the hexagonal border—and by 1977, the ubiquitous six-point blue star symbol was trademarked by the National Highway Traffic Safety Administration (NHTSA). Since then, according to a memorandum from the NHTSA issued in the fall of 1977, the symbol could be used by EMS vehicles to indicate that they met federal standards, as well as EMS personnel to show that they were qualified to provide emergency care. That is still the case today.

Is it mandatory for all ambulances to feature the Star of Life?

It’s not legally required by law. But if an ambulance is certified to provide emergency medical care, it is allowed to use the Star of Life symbol as a means of identification.

To display the Star of Life, an ambulance has to satisfy certain federal requirements—federal standards for ambulance design, manufacturing and construction. Components like the size of the patient compartment, ventilation, medical equipment storage, heating and cooling systems, patient and attendant seating and lighting must all meet federal specifications to ensure patient safety and care. When those specifications are met, the ambulance manufacturer can issue a certification to the purchaser of the ambulance that indicates it meets federal safety standards and can be considered a certified Star of Life ambulance and can use the symbol on its vehicles.

Is the Star of Life only on U.S. ambulances?

Nope! While the Star of Life is a federally registered icon in the U.S., it’s become synonymous with emergency medical care around the world.

Where else does the Star of Life appear?

The Star of Life doesn’t just appear on your local ambulance or EMS personnel uniform. You’ll also find it on maps and highway signs to indicate medical centers with emergency medical services or on medical bracelets to let EMS know of certain medical conditions or to use specific treatments. It’s also found on books, pamphlets or reports that are directly associated with an EMS organization, as well as medical equipment used specifically by EMS personnel when providing emergency care.

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Alexandra Kelly
Alex Kelly is a writer and editor based in New York's Hudson Valley. She has been an editor for U.S. News and World Report, Reader's Digest and The Huffington Post, covering everything from lifestyle to commerce content. Alex graduated with a bachelor's degree in Journalism and Religious Studies from New York University. When she's not writing or e...
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