EMERGENCY ROOM MAY BE SHUT AT BASE : PLAN CALLS FOR PARAMEDIC SERVICE.

Byline: Charles F. Bostwick Daily News Staff Writer

Edwards Air Force Base officials are considering shutting down the emergency room at the base hospital.

Instead, paramedics would take patients to hospitals 25 minutes away in Lancaster. There also would be expanded clinic hours and an on-call physician for nights on base.

``The plan, if we get permission, we really do strongly feel will improve the level and quality of service we are able to offer,'' said Col. Roger Bisson, commander of the 95th Medical Group on the base.

Shutting the emergency room and contracting with a private ambulance company - at an estimated total cost of about $400,000 a year - requires getting permission from Air Force officials in Washington, D.C.

The change will not happen soon. Permission could come no sooner than September because of regulations establishing a six-month period for public comments, Bisson said. Then, implementing the change could take 12 to 24 months.

Officials said doctors, nurses and other staff from the emergency room would be reassigned to clinic duties, opening up nearly 20,000 appointments per year for patients, officials said.

The emergency room had more than 11,000 walk-in nonemergency cases in 1996. Only 1 percent of emergency room visits involved immediate threats to life, limb or sight, Bisson said.

``We're putting in a lot of resources to taking care of . . one or two emergencies a night,'' he said.

The 17-bed hospital's emergency room is rated a Level III emergency room, not as well equipped or staffed as the Level II emergency rooms at Antelope Valley Hospital and Lancaster Community Hospital, Bisson said.

At Edwards, X-ray and laboratory technicians must be called in at night, while they are on duty around the clock at Antelope Valley and Lancaster Community. The civilian hospitals also have surgical staff on call.

The base hospital lacks a computerized tomography scanner, must be used on stroke patients before they are given new anti-clotting agents, Bisson said.

``Time is obviously precious,'' Bisson said. He said time is lost when, for example, a stroke victim needing CT scanning is brought first to the base emergency room rather than directly to a Lancaster hospital.

For many medical emergencies - as when a baby has a high fever or a teen needs stitches for a cut - Edwards residents could still get treatment at the base before and after regular clinic hours, Bisson said.

Residents would be able to telephone a triage nurse, who would assess the ailment, offer advice, set up an appointment during clinic hours or call in a physician to open up a clinic and treat the patient.

Changing to paramedic ambulance service will improve the care patients can get on the ride to the hospital, Bisson said. Ambulance service now used by the base is staffed by emergency medical technicians, who have received less training and are permitted to perform fewer procedures than paramedics do.

Paramedics, for example, are allowed to inject key drugs and use defibrillation on heart attack patients, but emergency medical technicians are not.

Officials expect that most Edwards patients would not have to pay for the ambulance ride. Treatment in a civilian emergency room will cost $10 for lower-ranking personnel and $30 for higher-ranking personnel under the Air Force's TriCare Prime insurance plan, which is free to Air Force personnel and their dependents.