There are two symbols which are most readily identified with the fire service and the emergency medical service. They are the Maltese Cross and the Star of Life, respectively. It is not uncommon to find a Maltese Cross incorporated into the insignia of a fire department or an individual unit. The Star of Life always represents that the person bearing it has some level of emergency medical training. Many municipalities have consolidated fire and EMS departments, and many firefighters are also certified as first responders or higher, so it is not uncommon to find both symbols used conjointly. Here is a brief history regarding both symbols.

The Maltese Cross is a symbol rooted in Christianity and the exact history of it's evolution are arguably unclear. There have been several variations of the Maltese Cross throughout history, including the modern form which the fire service utilizes today. Generally, the accepted form of the true Maltese Cross is a cross made from four straight-lined pointed arrowheads , meeting at their points, with the ends of the arms consisting of indented "V's".

How the symbol came to be identified with the fire service is a bit more clear. Early in the 11th century, the Order of the Knights Hospitaller had established a hospital in Jerusalem to assist pilgrims in the land. They would later become the Knights of St. John, but would continue this tradition of charity and and compassion for centuries.

The Knights of St. John fought in the Crusades and because armor covered their entire body, they needed something to identify themselves as friend on foe on the field of battle. They chose an eight-pointed cross. As the Knights engaged the Saracens in an attempt to win back the Holy Land, the Saracens used a terrible weapon against the Crusaders. They would hurl glass vials at the warriors containing a gelatinous, flammable liquid made mostly from naphtha, known to the Europeans as "Greek Fire."

After the Knights had become saturated with the concoction, flaming torches would be hurled at them thus setting the Knights on fire, burning many alive. Numbers of Knights risked their own lives to save their brothers from the fiery death. Similar tactics were employed by the Saracens when they sailed vessels containing naphtha, rosin, sulphur and flaming oil into the ships of the Knights of St. John. Again, many rose to do heroic deeds by rescuing companions and extinguishing fires.

Modern Maltese Cross with "fire scramble"

In essence, these were the first fire fighters. Their heroic efforts were recognized by fellow Crusaders who awarded each a badge of honor similar to the one fire fighters wear today.

Eventually the Knights of St. Johns came to settle on the island of Malta where they once again took to caring for those who were in need. This is how the the eight-pointed cross came to be associated with Malta, those who were willing to care for others in need, and those willing to brave a fiery death to try and help others so that they might live also.

Today, modern fire fighters wear this symbol as a badge of protection and honor.

The Star of Life is a relatively new symbol but a part of it might actually pre-date the Maltese Cross. The serpent entwined around the rod is known as the Staff of Asclepius.  This is not to be confused with the Caduceus of Hermes which is a rod wrapped by two snakes and crowned with a pair of wings, also commonly associated with medicine.

Although it is believed that Asclepius actually existed in Greece around 1200 B.C. and was probably a skilled physician, he eventually transcended into mythology. Medical schools called Asclepions were very important in Greek society and were usually associated with temples or shrines. Harmless snakes were kept in these facilities in honor of the god.

Myth says that the centaur Cheiron taught Asclepius about medicine and healing. Asclepius once had a patient who was too difficult to cure, so he consulted a snake for advice. The snake coiled itself around his staff so he could be head-to-head with Asclepius and equal while talking. Asclepius became so skilled that he once resurrected a mortal. This upset Zeus who struck Asclepius down with a bolt of lightning, but then later brought him back to life making him a god and placing him in the stars as the serpent-bearer.

Still, another possibility exists as to how this symbol came to be associated with medicine. Parasitic worm infections were a common malady in ancient times. The filarial worm crawled around the patient's body just below the skin. Practitioners would treat this by slitting the skin just in front of the worm's path. As the worm crawled out, the physician would carefully wind the parasite around a stick until is was removed entirely. It is believed that this type of infection was so common that physicians would advertise their services by hanging signs illustrating a worm on a stick.

In the 1960's and 70's, EMS organizations were utilizing a red cross for identification. The American Red Cross had the symbol trademarked and objected vigorously to it's use, so in 1973 Leo R. Schwartz, Chief of the EMS branch for the National Highway Traffic Safety Administration developed a new symbol. He took the Medical Identification Symbol (Medic Alert) of the American Medical Association, changed it from red to blue, added the Staff of Asclepius, and placed it on a white square.

The six bars of the star represent the six phases of an EMS response: detection, reporting, response, on-scene care, care in transit, and transfer to definitive care. The Star of Life signifies that a responder has emergency medical training.