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Building a lifesaving network: public access defibrillation across the challenging terrain of Crete[1]

Darivianaki P, Spartinou A, Protopapa I, Karageorgos V, Stathiakis N, Fraidakis O, Nyktari V, Papaioannou A · 2026 · Rural Remote Health

Summary

Design and first-8-months evaluation (March-October 2025) of Program ZOE, the first organized public access defibrillation (PAD) programme in Greece, across the Region of Crete. 256 AEDs were sited by a population criterion across urban and rural areas - 67 in athletic fields and stadiums, 97 urban, 92 in villages - with a mobile app to locate the nearest AED and give CPR instructions, plus a 45-minute video-based mass-training programme (over 1,500 high-school students trained across two academic years). In the first 8 months the network's AEDs were used six times for OHCA, all in rural areas; one resuscitation succeeded (a home arrest where relatives did CPR and retrieved the village AED, three shocks, ROSC before EMS). The authors conclude remote communities with difficult EMS reach benefit most, and that PAD network design must account for the area's geomorphology.

So what

A concrete, recent template for the venue-AED-programme side of the cardiac-arrest shelf, with two transferable design lessons: site AEDs against a population/access criterion (here, 67 explicitly at athletic fields and stadiums) and pair the hardware with a locator app and mass lay-training - the network is device + finder + trained bystander, not devices alone. The early-yield profile is honest and useful (6 uses / 8 months, mostly where EMS reach is slow), matching the surveillance-stack economics the library favours: high readiness, low absolute activation, value concentrated where response time would otherwise be long. Supports the merchant-2026 bystander-training entry (the human layer) and the future AED-programme page.

Key findings

  • Program ZOE, Crete — first organized PAD network in Greece; 256 AEDs
  • Siting: 67 in athletic fields/stadiums, 97 urban, 92 villages (population criterion)
  • Network = AEDs + locator/CPR mobile app + 45-min video mass training (>1,500 students)
  • First 8 months: 6 OHCA uses, all rural; 1 success (bystander CPR + village AED, 3 shocks, ROSC pre-EMS)
  • Design lesson: match PAD siting to geomorphology/EMS-reach; device+finder+trained bystander together

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