In June of 1976, the patch that is presently worn on the left sleeve of the uniform by all City & County of Honolulu EMS (Emergency Medical Services) personnel was adopted as a part of the official uniform of the Emergency Medical Services.

The research and design of the patch incorporated the old with the new. Each color and each symbol represents a part of Hawaiian heritage or a part of the Emergency Medical Services.

The center of the patch is the shield which was adapted from the precursor of Hawaii's Coat of Arms which was prepared in London in 1843-44. The shield is divided into quarters: the white, red and blue stripes in the first and fourth quarters; and the Kapu shaft with the EKG waves; running horizontally across the Kapu shaft back dropped in a field of green appear in the second and third quarters of the shield.

• The white, red and blue stripes represents the stripes of the Hawaiian flag.
  
  

• The Kapu sticks (Puloulou) composed of a white ball on the top of a brown wooden shaft were the symbols of the Kahuna of old Hawaii. Kahuna means the "Gifted One." They were men of intelligence and were trained in the healing arts as are the paramedics of the Emergency Medical Services.
  
  

• The EKG waves across the Puloulou shaft represents modern medicine.
  
  

• The field of green represents the Islands which are rich in foliage and distinctive of the Hawaiian Islands.
  
  

• The Aesculapius with a single serpent symbolizes the paramedics of the Emergency Medical Services.
  
  

• The field of red honors those who have died while in the service of the Emergency Medical Services.

The pride with which the emblem is worn provides the true meaning of:
`O KA MEA MA`I KA MUA