A pair of Oak Leaf insignia with a blue Star of Life in the center.
The 7/8" wide Oak Leaf Rank in polished gold with the Star of Life is typically worn on the shirt collar of mid-echelon commanders in Emergency Medical Service Units.
The 1 1/8" wide Oak Leaf Rank in polished gold with the Star of Life is typically worn on the coats or blazers of mid-echelon commanders in Emergency Medical Service Units.
Some organizations use silver or gold to designate whether a person has seniority with the unit.