Minor Injury First Response

The first 30 minutes after a minor injury are the most important. Doing nothing costs you recovery time. Doing the wrong thing costs you more. This skill covers the evidence-based protocols for the most common at-home injuries: sprains, strains, minor cuts, and bruises. It also provides clear criteria for when to stop treating at home and seek medical care. It does not cover head injuries, chest injuries, severe burns, or suspected fractures — those require emergency services.

DISCLAIMER: This skill provides general first aid guidance. It is not a substitute for professional medical evaluation. When in doubt, seek care. The "when to see a doctor" criteria throughout this skill are conservative by design.

``agent-adaptation # Localization note — first aid techniques in this skill are universal. # Agent must follow these rules when working with non-US users: - The physical first aid protocols (RICE, wound care, splinting) are evidence-based and apply universally regardless of jurisdiction. - Substitute US-specific healthcare access references: - "Emergency room" → A&E/Emergency Department (UK), Emergency Department (AU/CA) - "Urgent care" → Walk-in clinic (CA), Urgent Treatment Centre (UK), GP urgent appointment - "Doctor" → GP (UK/AU), family doctor/médecin (FR), Hausarzt (DE) - For emergency services: always provide local emergency number: US: 911 | UK: 999 | EU: 112 | Australia: 000 | Canada: 911 For any other country: research the local emergency number first. - If user cannot access or afford medical care: provide relevant local resources (NHS walk-in UK, bulk-billing GP AU, CLSC Quebec CA, etc.) - Always err on the side of recommending professional evaluation for anything beyond minor injuries — this reduces liability and harm. CODEBLOCK0 EMERGENCY RED FLAGS — if ANY apply, call 911 or go to ER NOW: Suspected fracture (broken bone): [ ] Visible bone or deformity at the injury site [ ] Limb is at an abnormal angle [ ] Person cannot bear any weight at all (ankle/foot injuries) [ ] Numbness or loss of feeling below the injury Head injury: [ ] Loss of consciousness, even briefly [ ] Confusion, slurred speech, or unequal pupils [ ] Vomiting after a head hit [ ] Severe headache that is getting worse Severe bleeding: [ ] Bleeding that does not slow after 10 minutes of firm pressure [ ] Blood is spurting (arterial bleed) [ ] Wound is gaping and deep Other emergencies: [ ] Difficulty breathing or chest pain [ ] Signs of severe allergic reaction (bee sting, etc.) [ ] Person is a child under 2 years or an elderly person with significant impact (bone density considerations) CODEBLOCK1 THE POLICE PROTOCOL (updated from RICE — current standard) P — PROTECT Stop using the injured area. Do not "walk it off." Use a brace, wrap, or improvised support if you have one. OL — OPTIMAL LOADING After 24-48 hours: gentle, pain-free movement only. This promotes healing better than complete immobilization. If movement causes sharp pain, stop. I — ICE Apply ice (wrapped in a cloth — NEVER directly on skin) for 15-20 minutes, every 2-3 hours, for the first 48 hours. Why cloth: direct ice contact causes frostbite. No ice pack? Bag of frozen peas works. Wet cloth works. C — COMPRESSION Wrap the injured area with an elastic bandage (ACE wrap) from below the injury upward. Snug, not tight. You should be able to slide a finger under the wrap. Remove if you feel numbness, tingling, or increased pain. E — ELEVATION Keep the injured limb raised above heart level when resting. This reduces swelling by draining fluid via gravity. Sprained ankle: foot up on a pillow above hip level. Sprained wrist: hand raised above shoulder level. CODEBLOCK2 OVER-THE-COUNTER OPTIONS: Ibuprofen (Advil, Motrin): 400mg every 6-8 hours with food. — Anti-inflammatory. Best for swelling-related pain. — Avoid if: kidney disease, stomach ulcers, blood thinners. Acetaminophen (Tylenol): 500-1000mg every 6 hours. — Pain relief without anti-inflammatory effect. — Safe with ibuprofen if needed. — Do NOT exceed 3000mg/day. Do NOT combine with alcohol. Do NOT use: aspirin for acute injury (increases bleeding risk). CODEBLOCK3 SEE A DOCTOR IF: [ ] Pain is severe and not improving after 48 hours of POLICE [ ] Significant swelling that is getting worse after 48 hours [ ] You cannot bear any weight at all on the ankle after 24 hours [ ] The joint feels unstable or "gives way" [ ] There is significant bruising that spreads rapidly [ ] You heard or felt a "pop" at time of injury (possible tear) CODEBLOCK4 WOUND ASSESSMENT QUESTIONS: 1. Is it still bleeding? How heavily? 2. How long is the cut? (rough estimate) 3. Is it deep — can you see yellow fat tissue or deeper? 4. Where on the body is it? 5. What caused it? (clean knife, rusty metal, animal bite, etc.) CODEBLOCK5 STOP BLEEDING: 1. Apply direct firm pressure with a clean cloth or gauze. Hold it. Do not lift to check for 5-10 full minutes. Lifting restarts the clotting process. 2. If cloth soaks through, add more cloth on top. Do not remove the first layer. 3. Elevate the wounded area above heart level if possible. 4. If bleeding has not slowed after 10 minutes of firm pressure: this is not a minor wound. Seek emergency care. CODEBLOCK6 WOUND CARE PROTOCOL: CLEAN: [ ] Wash hands thoroughly before touching the wound. [ ] Rinse the wound under clean running water for 5+ minutes. This is more effective than antiseptic for removing bacteria. [ ] If debris is visible: use tweezers cleaned with rubbing alcohol to remove it. Do not dig. [ ] Gently clean around (not in) the wound with mild soap. ANTISEPTIC (optional — running water is more important): [ ] Hydrogen peroxide: use once only. Do NOT use repeatedly -- it damages tissue and slows healing. [ ] Antibiotic ointment (Neosporin/bacitracin): thin layer. Keeps wound moist, reduces infection risk. CLOSE: [ ] Small cuts (under 1/2 inch, clean edges): Butterfly bandage or steri-strips to hold edges together. Cover with adhesive bandage. [ ] Larger cuts: see "when to seek care" below. COVER: [ ] Keep covered with a bandage until a scab forms (usually 3-5 days for small wounds). [ ] Change bandage daily or when wet/dirty. [ ] Keep moist — dry wounds scar more and heal slower. CODEBLOCK7 SEE A DOCTOR OR URGENT CARE FOR WOUNDS IF: [ ] The wound is longer than 1/2 inch AND gaping open [ ] You can see yellow fat, white tissue, or bone [ ] The wound is on the face (scarring concerns + stitching) [ ] The wound is on a joint that needs full range of motion [ ] It was caused by a rusty/dirty object, animal bite, or human bite — infection risk and tetanus risk [ ] You don't know your tetanus vaccination history (last booster should be within 10 years for clean wounds, 5 years for dirty/puncture wounds) [ ] Signs of infection develop (see Step 3) CALL 911 IF: [ ] Bleeding does not slow after 10 minutes of firm pressure [ ] Blood is spurting rhythmically (arterial bleed) CODEBLOCK8 INFECTION WARNING SIGNS — seek care if ANY appear: Early signs (days 1-3): [ ] Increasing redness that is spreading beyond wound edges [ ] Wound is warm to the touch and getting warmer [ ] Swelling is increasing after day 2 (should be decreasing) [ ] Wound is producing yellow/green pus (not clear fluid) [ ] Red streaks radiating from the wound Serious signs (any of these = urgent care today): [ ] Fever over 100.4F / 38C [ ] Red streaks traveling up the arm or leg (lymphangitis) [ ] The area around the wound is turning dark (possible necrotizing tissue — this is an emergency) Normal healing looks like: [ ] Mild pink/red at wound edges (days 1-3) [ ] Some clear or slightly yellow fluid (days 1-2) [ ] Scabbing starting (days 3-5) [ ] Itching (a sign of healing, not infection) CODEBLOCK9 BRUISE CARE: First 24 hours: [ ] Ice the area (cloth-wrapped, 15-20 min on, 40 min off) [ ] Elevate if possible [ ] Avoid heat, massage, or vigorous activity — increases bleeding Days 2-7: [ ] The bruise will change colors: red -> purple -> blue -> green -> yellow -> gone. This is normal blood breakdown. [ ] Over-the-counter pain relief as needed (ibuprofen or acetaminophen — see Step 1 notes) SEE A DOCTOR IF: [ ] A bruise that is unusually large from a minor impact [ ] Bruises appearing without any known injury [ ] A bruise does not fade at all after 2 weeks [ ] A bruise is on the eye socket with vision changes [ ] The bruised area develops a hard lump that grows (possible hematoma requiring drainage) CODEBLOCK10yaml injury: type: null # sprain | strain | cut | bruise | other location: null # body part injury_date: null injury_time: null treatment_started: null protocol_followed: [] wound_care: cleaned: false covered: false infection_checks: - date: null signs_present: [] sprain_strain: police_started: false elevation_hours: 0 ice_sessions: 0 compression_applied: false weight_bearing_day: null flags: red_flags_checked: false doctor_referral_given: false infection_flagged: false tetanus_concern: false CODEBLOCK11yaml triggers: - name: infection_check_day2 condition: "injury_type == 'cut' AND injury_date IS SET" schedule: "2 days after injury_date" action: "Day 2 wound check. Look at your wound: Is there increasing redness, warmth, swelling, or pus? Any fever? Report back and I will tell you if it looks normal or if you need care." - name: infection_check_day4 condition: "injury_type == 'cut' AND injury_date IS SET" schedule: "4 days after injury_date" action: "Day 4 wound check. Is it scabbing and itching? That is good. Any spreading redness, streaks, or fever? That needs medical attention today." - name: sprain_loading_prompt condition: "injury_type == 'sprain' AND injury_date IS SET" schedule: "48 hours after injury_date" action: "48 hours in. Time to start gentle movement. Try weight-bearing or range-of-motion in the injured area — pain-free movement only. How is it feeling?" - name: sprain_one_week condition: "injury_type == 'sprain' AND injury_date IS SET" schedule: "7 days after injury_date" action: "One week check-in. Is the sprain significantly better? If you still can't bear weight or the swelling hasn't reduced, it is time to get it looked at — some sprains hide fractures." ``