Rural and Remote Health

www.rrh.org.au
James Cook University ISSN 1445-6354

Project Report

Building a lifesaving network: public access defibrillation across the challenging terrain of Crete

AUTHORS

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Panagiota Darivianaki1

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Anastasia Spartinou1 PhD, Anaesthesiologist *

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Ioanna Protopapa1

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Vlasios Karageorgos1

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Nikos Stathiakis2

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Othon Fraidakis1

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Vasileia Nyktari1

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Alexandra Papaioannou1

AFFILIATIONS

1 Cardiopulmonary Resuscitation Laboratory, School of Medicine, University of Crete, Heraklion, Crete, Greece

2 Institute of Computer Science, Foundation for Research and Technology – Hellas, Greece, Heraklion, Crete, Greece

ACCEPTED: 11 June 2026


Early Abstract:

Aim: This study aims to present the design and implementation of the first organized Public Access Defibrillation (PAD) programme in Greece – ZOE (LIFE in Greek) programme and the results collected over the first 8 months of its operation (March 2025 to October 2025).
Methods: We prospectively assessed the use of AEDs in the Region of Crete. Data was collected from the online defibrillator monitoring system, EMS, and interviews from people engaged in resuscitation. The Region of Crete purchased 256 automated external defibrillators (AED). We used a population criterion to determine the locations of installation to cover urban and rural areas of Crete. A mobile app was created to guide retrieval of available AED and to provide CPR instructions. To allow mass training, we designed a 45 min training programme with the use of an educational video.  
Results: More than 1500 high school students were trained through the short programme during the Academic years 2023-24 and 2024-25. Sixty-seven AEDs were placed in athletic fields and stadiums, 97 in urban areas and 92 in villages. Ninety were placed in the regional unit of Heraklion, 42 in Chania, 31 in Rethymnon and 26 in Lasithi. During the first 8 months, AEDs of ZOE programme were used six times for the management of OHCA, all in rural areas.  In one case, resuscitation was successful; the victim suffered cardiac arrest at home and relatives performed CPR and called for the AED located in the village. The patient received three shocks and regained consciousness before EMS arrival.
Conclusions: Our 8-months experience suggests that remote communities with relatively difficult EMS reach may benefit from AED installation. When designing a PAD network, we should take into consideration the specific geomorphological features of the area.
Keywords: AED, automated external defibrillators, cardiopulmonary resuscitation, CPR, OHCA, out-of-hospital cardiac arrest, PAD, public access defibrillation.