Thousand Islands Emergency Rescue Service (TIERS)

What does a young man, recently graduated from high school, do when his mother says, “You need find something to do that interests you.” He volunteers as an ambulance driver in Evans Mills. From this inauspicious start, he progresses to training for 6 months as an Emergency Medical Technician (EMT), and then to school for two years to become a paramedic. Today, Tim Farrell Jr. is the Executive Director of the Thousand Islands Emergency Rescue Service, Inc, commonly referred to as TIERS. Tim is the third Executive Director, following Rolly Churchill, who was instrumental in the creation of TIERS, and Mike Bennett, who continued to build TIERS. Tim took over in 2024.

EMTs are front-line responders trained to provide basic emergency care. They provide vital out-of-hospital basic life support, stabilization, and transport for patients in crisis. Paramedics are highly trained medical professionals who provide emergency care, including administering medications, performing life-saving procedures, and managing critical patients, playing a vital role in pre-hospital care and patient survival.

TIERS was established as a non-profit organization by a group of forward-looking individuals who recognized the decline in volunteer EMS availability and the need for advanced medical training in the Clayton and Orleans communities. It provides emergency medical services, pre-hospital care, and transportation to a hospital, as well as providing emergency rescue operations and/or lifesaving activities for people who are stranded, lost, accident victims, or other life-threatening dangers.

It consolidated the ambulance services of Clayton/LaFargeville. Its mission is as
follows:

TIERS provides the residents of Clayton and Orleans Townships with the
highest level of professional emergency medical care available, with on duty paramedical level responders available 24/7.

The five core values that guide them are:

Quality of Emergency Care, Patient Centeredness, Safety First, Teamwork, and Cost Effectiveness.

The Board of Directors of TIERS is responsible for providing governance and oversight of strategy, operations, and management. It oversees the senior management to whom it has entrusted the day-to-day operation. The current Chair is Joe Colello, a former EMT and now a respiratory therapist at local hospitals. In addition to ED/Chief Tim, there is a Director of Operations/Deputy Chief Nathan Peters, and a paid staff of approximately 40, of which 15 to 20 constitute the core, incorporating hundreds of hours of training, practice, and testing of knowledge and skills.

TIERS is on duty 24/7/365, meaning that at any time a paramedic and an EMT are in residence. Paramedics work 24 hour shifts and EMTs 8 hour shifts. TIERS responds to an average of 3 to 4 calls a day, more than 1300 calls in a year. During the summer months, TIERS can be found on the River treating boaters, islanders, and vacationers. You may see the boat, Last Chance, speeding past carrying a fireman, paramedic, and an EMT. TIERS is also part of the safety committee standing by when the POKER races are run.

Ambulances deliver patients to hospitals throughout the North Country, providing the very best pre-hospital care possible. They also provide emergency rescue operations and/or lifesaving activities for people who are stranded, lost, accident victims, or exposed to other life-threatening dangers. TIERS has four ambulances, all on a 12-year replacement schedule. Each ambulance costs between $260,000 to $270,000. The power stretcher system alone costs $60,000. There is also the Fly Car, equipped with everything found in an ambulance, used as support and response to medical assistance not requiring transport.

In addition to the support from the Townships, TIERS actively fund raises more than $100,000 annually through grants, donations, their Life Saver campaign, and special events. Special events include one held this year at the Clipper Inn on April 15th, where more than 950 meals were provided. Their 2nd Annual Gala is scheduled for August 15th at the Absolute Breeze Event Center, for which tickets and sponsorships are available. TIERS also offers classes on CPR and First Aid. Classes envisioned for the future include training inspectors to ensure that car seats are safely installed and used correctly. For more information, check out their website at tirescue.org.

TIERS offers a Junior Program for young adults from 14 to 17 years of age, which is geared towards health care careers. The students go on calls where they see firsthand the care provided. Seventy-five percent of those students go on to careers as EMTs and Paramedics. TIERS also offers scholarships, funded through donations channelled to their Friends of TIERS, to high school students from LaFargeville and Thousand Islands Central High Schools

Ambulance services have evolved from 11th century battlefield litters to modern paramedic staffed medical units. Early emergency vehicles were primitive, beginning with carts, litters suspended between two poles, and even a donkey used in the care of the Good Samaritan from the New Testament. The first use of a specialized vehicle in battle came about with ambulances designed by Napoleon Bonaparte’s chief surgeon, Dominique Jean Larrey. He was distressed that wounded soldiers were not picked up until after the battle had ended. His “flying ambulances” were used to transport the wounded from the battleground so that they could receive treatment. More advances in medical care were made during the United States Civil War, when the “Rucker” ambulance, named for Major General Rucker, a four wheeled design that accommodated more than three patients, came into use.

The first known hospital-based ambulance service for civilians operated out of Commercial Hospital in Cincinnati, Ohio, followed shortly by Bellevue Hospital in New York City, which carried medical equipment such as splints, a stomach pump, morphine, and brandy. The horse drawn ambulance gave way to the motorized ambulance in the last year of the 19th century, with the Michael Reese Hospital in Chicago taking delivery in 1899. The first gasoline powered ambulance was introduced in 1905. During the first half of the twentieth century, many civilian ambulances were run by funeral homes. These were largely untrained and unregulated services. In 1967 the Freedom House Ambulance Service was founded in Pittsburgh. This was the first MT/Paramedic service in the US to be staffed by residents trained in advanced life support.

Unfortunately, there is a systemic shortage of paramedics and EMTs (although not currently in Jefferson County). The average time spent as an EMT is five years. Suicide rates for Emergency Medical Service (EMS) providers are significantly higher than the general population. These providers deliver high-quality, life-saving services for medical and traumatic emergencies on a moments notice. These services can be emotionally distressing for EMS providers, as they witness illness, injury, and death among children and adults. Therapy and counselling, as well an outside hobby, often provide the help necessary to maintain a balanced life. Tim is a Race Director for the Super Dirt Car Series, officiating at events within the states.

The next time one goes flying by you racing to provide help, take a moment to reflect on the essential service the crew is providing. Fortunately, it is not for you this time . . . but the next . . .

After a personal encounter with the crew of an ambulance, I thank and salute Bill Solar, Pat Thomas, and Tim for the essential lifeline that they provide.

By Allison Burchell Robinson

Allison Burchell-Robinson's great grandfather built a cottage on Wyoming Island in 1910, and five generations have followed. She spent her childhood summers in the River, on the River or by the River. Eventually, she and her husband moved to an island in Ivy Lea Group. She is happy to return every summer to enjoy, relax and rejuvenate in an area her son referred to as the most beautiful place in the world. Many will recognize Allison for her many years of service to the Thousand Islands Association TIA serving as President then Secretary/Treasurer, and until recently, editor of TIA's "River Talk". Allison joined the TI Life team this summer and you may see her contributions here.

All photos courtesy of Timothy R. Farrell Jr. AEMT‑P Executive Director, Thousand Islands Emergency Rescue Service, Inc.