Living up to the reputation of being "that place" capable of handling any medical emergency, Inova Fairfax broke ground recently to add 11,000 square feet to the existing 20,650 square feet that are being remodeled at the area’s only Level 1 trauma center.

A Level 1 emergency is the worst injury scenario designated by the medical establishment, and Inova Fairfax is the only one in the Northern Virginia area designated to handle that level.

"This is 'that place.' Anything and everything can come to Inova Fairfax Hospital," said Robert Cates, M.D., chairman of the Emergency Department at Inova Fairfax.

Patients from all over the area are taken here, and according to hospital figures, the new facility will enlarge its capacity from being able to handle 72,000 emergency patients, as it did last year, to accommodating at least 80,000 when completed. Cates talked about the 80,000 figure as a base line, with internal maneuvering to make the new facility even more expandable than that, even though the land the hospital is on is limited. Some areas designed for one bed can be reconfigured to hold two, and other things can be redesigned to hold more, if needed.

"You do have a bit of flexibility. That's based on growth we've had in the past. The footprint didn't change a lot, but the potential is there," he said.

The timing of the expansion seems to be in line with the homeland defense efforts, and Inova Fairfax did take part in some of the efforts the day the Pentagon was hit, but the emergency room project was planned a few years ago, before 9/11. The facilities available were altered a bit to cater to biohazards, though.

"Certain provisions are being made for decontamination. Some of the facilities have been modified for the threats," he said.

Inova Fairfax owns its own helicopter, unlike other hospitals in the area, according to Inova representative Courtney Prebich. This is important for traumas as well as inter-hospital transfers.

"We work closely together," Prebich said. "That [helicopter] is almost a necessity."

There is a heliport on the grounds and the roof of the main building. The emergency addition will have a heliport with direct access.

"We've had military helicopters come here. Some of the big ones can use the ground pad," he said.

CATES HAS BEEN with Inova since November 1975, when the hospital was just a facility the size of the current women and children’s area. The current emergency room was built in early 1987. Cates has seen the hospital grow as well as the area, which is the main reason for the emergency room additions. The three county clinics in Reston, Baileys Crossroads and south Alexandria have filled to capacity, and the addition of the Inova Healthplex in Springfield has not made a noticeable difference, according to Cates.

"Not that we can tell," he said, of the Springfield addition.

He compared it to adding a lane on a highway, not that noticeable. People seem to look at availability.

"We're in such a boom in Northern Virginia," he said.

BELINDA SWAIN was waiting for her brother at 2 o’clock on a Thursday afternoon. There were 13 people in the waiting room, which didn't appear crowded, though she'd waited two hours before her brother was seen by a doctor. She didn't know about the expansion.

"It looks pretty nice in here now as it is. The wait's pretty long," she said.

Out front by the valet parking, security officer Sean Chisley has seen it get crowded.

"They definitely need to expand it. You always want to make the situation better," he said.

Construction on the addition started in mid-September and is expected to be completed in Spring 2005. It will cost $18 million.