The Washington Hospital Center's MedSTAR emergency medical facility has been officially designated as the District of Columbia's adult trauma center for receiving patients transported by helicopter.

At the same time, D.C. Department of Human Resources Director Albert Russo announced yesterday that the trauma services at Georgetown and George Washington University medical centers also have been designated adult trauma centers after they met newly established city standards for such facilities.

Yesterday's action was the first major step in changing the traditional system of ambulance service in the District, a system that requires that a patient be taken simply to the nearest hospital best equipped to deal with the patient's particular injury or illness.

Additionally, the designation of a single facility as the city's trauma unit for helicopter-borne patients eliminates a major stumbling block that prevented the Maryland State Police from flying in patients seriously injured in counties near Washington to the hospital center rather than to the Shock-Trauma Unit in downtown Baltimore.

Maryland officials have long held that they could not work out a cooperative system with the District of Columbia until it designated a city trauma center.

Russo said yesterday that Mayor Marion Barry had sent a letter to Maryland Gov. Harry Hughes, urging him to permit Maryland helicopters to carry patients to the hospital center when necessary.

An aide to Hughes said the governor could not comment on the situation until he received Barry's letter.

Maryland officials have been criticized in the media and medical community for their refusal to allow seriously injured patients to be transported to the hosptial center, some of whom have been flown across parts of the District on their way to Baltimore for treatment.

Maryland does, however, allow its helicopters to transport children to Children's Hospital National Medical Center here, landing the helicopters on the hospital center's pad; allows the transportation of eye injury cases to Georgetown and the delivery of burn patients to the hospital center's burn treatment unit.

Maryland officials have never explained why they allow patients to be flown to these hospitals and services, which had no special designation, and not to the hospital center's MedSTAR Shock-Trauma unit.

DHR Director Russo said yesterday that the standards now being used to designate trauma units in the District differ from those established nationally by the American College of Surgeons.

Russo said four more hospitals -- Howard University, D.C. General, Greater Southeast and Providence -- would be surveyed in the next few months.Howard, said Russo, probably will be designated a trauma center soon.

Once those hospitals have been surveyed, said Russo, city ambulance drivers will be instructed to take seriously injured patients to the nearest certified trauma center, rather than simply the nearest hospital.