By the end of its first week of operation, Reston's new free-standing emergency medical center had treated 210 patients - double what had been projected for patient turnout.

The patients came with ills ranging from cut fingers to coronary problems. Most received primary care at the center and we sent home. Four patients were transferred to Northern Virginia hospitals, according (FHA) which operates the ultra-modern facility at 11900 Baron Cameron Avenue.

The medical center is called ACCESS - which stands for Ambulatory Care Center - Emergency Services System.

"We've just started operation and already I can see need for expansion," said Dr. William Cassidy, chief physician at ACCESS and chairman of the Department of Emergency Services at Fairfax Hospital, also operated by the FHA. "Apparently there is even more need for emergency services in this area than we expected."

The 24-hour facility, which cost $1.2 million to build and $300,000 to equip with the latest in sophisticated, time-saving technology, was designed to take the place of a $10 million, 125-bed hospital proposed for the area in 1973.

Health planners determined then that Northern Virginia already had too many hospital beds, yet access to emergency medical facilities was needed by people in the northern fringes of Fairfax County. They estimated that it sometimes takes 40 minutes to reach Fairfax Hospital from the Herndon-Reston area.

"We believe that ACCESS is one of a kind in the country," said Jay Shiver, FHA assistant director of professional services. "We're not an outpatient center; we don't have doctors' offices here. We are an emergency center able to give essential primary care."

The center features five examination rooms, two specially equipped rooms to handle traumatized patients with cardiac and respiratory problems, a computerized laboratory, a room for applying casts to bone breaks and fractures, a police information-gathering area, an X-ray room, a private consultation room and staff-sleeping quarters among other facilities. All the rooms radiate from a central nurses station that gives direct view of patients under treatment.

This "radial" architecture allows for easy expansion and provides separate entrances for emergency patients and regular outpatients.

Most of the center's sophisticated equipment is designed to treat emergency patients with speed. The computerized laboratory can give test results to physicians in minutes, with only one lab technicia operating the equipment. Without the computrized technology, "it would take dozens of people and tons of apparatus" to give the same information after hours of work, Cassidy said.

A computer costing $90,000 does 29 automatic analyses of blood samples in seven minutes, a process that used to take hours of manpowers and "gallons of blood," Cassidy said. One mobile intensive care unit, a sophisticated ambulance, transmits patients' heart rates to the center through a system called telemetry. When the patient reaches ACCESS, treatment can begin immediately rather than waiting for an assessment of the patient's condition. Four of these types of ambulances are expected to be in operation by the end of the year.

Other types of transmitters can receive patients' medical history charts at the push of a button. The center's X-ray machine, located next to the emergency entrance, has a moveable table that allows minimum movement of the patient and an appartus that focuses on specific areas of the body to avoid overexposure to the rays.An automatic printmaker delivers X-rays prints within minutes that are projected on an X-ray view box for immediate examination by the physician.

A "poisindex" records 160,000 commercial products on microfiche that identify toixic substances in the products. Using this reference, physicians can advise people by phone how serious the consequences are if any of these products are taken internally.

A giant water pick cleanses severe open wounds by water pressure, removing debris like grass or gravel that can cause infection. A portable incubator can transport premature or sickly infants safely to a hospital. A mobile defibrillator can be moved wherever needed in the center to deliver shocks to a patient whose heart is stopped or traumatized.

The center also has its own small generator to provide electrical energy in case of power failure.

The regular staff of the center on duty around the clock, in shifts, includes one physician, two registered nurses, a nurses aide, a medical technologist, and X-ray technologist, a center manager during the day and a building supervisor at night.