Building a lifesaving network: public access defibrillation across the challenging terrain of Crete.
Rural and Remote Health · 2026-07-01 · Implementation & quality improvement
Abstract
INTRODUCTION: This study aims to present the design and implementation of the first organized public access defibrillation (PAD) program in Greece - Program ZOE ('life' in Greek) - and the results collected over the first 8 months of its operation (March 2025 to October 2025). METHODS: We prospectively assessed the use of automated external defibrillators (AEDs) in the Region of Crete. Data were collected from the online defibrillator monitoring system, emergency medical services (EMS) and interviews from people engaged in resuscitation. The Region of Crete purchased 256 AEDs. 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-minute training program with the use of an educational video. RESULTS: More than 1500 high school students were trained through the short program during the academic years 2023-24 and 2024-25. A total of 67 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 in Program ZOE were used six times for the management of OHCA, all in rural areas. In one case, resuscitation was successful; the patient experienced 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. CONCLUSION: Our 8-month 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.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Automated external defibrillator · Bystanders · Drones · Implementation · Rural & remote
Related articles
- "Drones are a great idea! What is an AED?" novel insights from a qualitative study on public perception of using drones to deliver automatic external defibrillators. (Resusc Plus, 2020)
- Barriers and enablers to public access defibrillation - an international RAND-UCLA consensus study. (Scand J Trauma Resusc Emerg Med, 2026)
- Out-of-Hospital Cardiac Arrest: Public-Access Defibrillation and System Approaches to Minimize Avoidable Delay. (J Clin Med, 2026)
- Drone-delivered automated external defibrillators in prehospital emergency care: implementation evidence, bottlenecks, and conceptual integration with artificial intelligence and next-generation communications. (Front Public Health, 2026)
- Drones delivering automated external defibrillators-Integrating unmanned aerial systems into the chain of survival: A simulation study in rural Germany. (Resuscitation, 2022)
- Automated external defibrillator delivery by drone in mountainous regions to support basic life support - A simulation study. (Resusc Plus, 2023)