A new study shows that a TXA autoinjector delivers lifesaving treatment for severe bleeding as effectively as traditional IV methods — but in under five minutes and without the need for medical expertise. This breakthrough could transform trauma care in emergencies, making rapid, easy-to-administer treatment available in settings ranging from battlefields to roadside accidents, where every second counts.
In a major breakthrough for emergency and trauma medicine, a group of researchers led by Prof. Arik Eisenkraft and Prof. David Gertz of the Institute for Research in Military Medicine (IRMM), Faculty of Medicine at The Hebrew University of Jerusalem, partnered with the IDF Medical Corps, have demonstrated that a simple autoinjector device can rapidly deliver Tranexamic Acid (TXA) — a drug known to significantly improve survival in severe bleeding — with the same effectiveness as traditional intravenous (IV) administration.
The study, recently published in the peer-reviewed journal Injury, highlights the potential for this technology to save lives in pre-hospital and battlefield settings, where timely intervention is critical and IV access may be delayed or impossible.
Addressing a Critical Challenge: Severe bleeding is the leading cause of preventable death in trauma situations, from combat zones to highway accidents. TXA, an antifibrinolytic drug that helps stabilize blood clots and reduce blood loss, is already widely used in hospitals and dedicated trauma centers and by pre-hospital emergency responders.. However, the standard IV method of administration can be difficult to perform in chaotic, high-stress environments, leading to dangerous delays in treatment.
Research has shown that for every 15-minute delay in administering TXA, its effectiveness drops by 10%, underscoring the need for a faster, simpler solution.
In the new study, the researchers found that TXA delivered via autoinjector reached effective therapeutic levels in less than five minutes and remained active throughout the treatment window.
Importantly, outcomes were comparable to intravenous delivery, with stable hemodynamic parameters and effective clot formation observed across all test subjects.
“When someone is bleeding heavily, every minute matters,” said Dr. Eisenkraft. “With this autoinjector, even non-medical responders can administer lifesaving treatment almost instantly — and that can mean the difference between life and death.”
“This innovation could transform trauma response in the field,” added Dr. Gertz. “From combat zones to roadside accidents and natural disasters, the ability to deliver a proven treatment quickly and easily has the potential to save countless lives.”
The simplicity and portability of the autoinjector device allow it to be used widely by paramedics, first responders, and military medics, ensuring that TXA can be administered within the critical early minutes following severe injury.
This research builds on ongoing efforts by Hebrew University and IDF scientists to improve emergency medical care in high-risk environments, ensuring that patients receive fast, effective interventions when and where they need them most.
The research paper titled “Autoinjector-Based Delivery of Tranexamic Acid Provides Pharmacokinetic Efficacy in a Porcine Model of Uncontrolled Hemorrhage” is now available in Injury and can be accessed at https://doi.org/10.1016/j.injury.2025.112721
Researchers:
Arik Eisenkraft1,2, Linn Wagnert-Avraham1, Rotem Azmon1,2, Michael Tabi1, Elon Glassberg3,4,5, Yoav Mintz6,7, Suhair Abdeen8, Muhammad Abdel-haq9, Abraham Domb1,10, Dean Nachman1,11, and S. David Gertz1,2,12
Institutions:
1 Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, Jerusalem, Israel;
2 Department of Military Medicine ("Tzameret"), Faculty of Medicine, The Hebrew University of Jerusalem, and the Israel Defense Forces Medical Corps, Jerusalem, Israel
3 The Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
4 The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
5 The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
6 Department of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem
7 Faculty of Medicine, The Hebrew University of Jerusalem
8 Department of Clinical Biochemistry, Hadassah-Hebrew University Medical Center, Jerusalem
9 Department of Medicinal Chemistry, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem
10 The Alex Grass Center for Drug Design and Synthesis and Center for Cannabis Research, Faculty of Medicine, Institute of Drug Research, School of Pharmacy, The Hebrew University of Jerusalem
11 Heart Institute, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem
12 The Saul and Joyce Brandman Hub for Cardiovascular Research and the Department of Medical Neurobiology, Institute for Medical Research (IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem