CRITICAL: Identify regenerator type before treatment initiation

  

  
• Complete template-based healing across all biological systems


  
• Will restore to pre-injury state without intervention, assuming survival


  
• Primary concerns: metabolic support, foreign object removal


  

  

  
• Template-based healing limited to specific systems or regions


  
• System boundaries require special attention


  
• Primary concerns: protecting regenerating systems, conventional treatment for non-template areas


  

  

  
• Accelerated natural healing without template guidance


  
• Follows normal healing pathways at enhanced speed


  
• Primary concerns: proper alignment before healing progresses, risk of improper healing


  

  

  
• LUMA card should indicate regenerative classification if available


  
• Medical alert jewelry often displays type and affected systems


  
• Licensed Vigilantes typically carry specialized medical information


  

  

  
• HTR: Wounds visibly closing in organized pattern from inside-out


  
• LTR: System-specific healing (e.g., bone realignment without soft tissue healing)


  
• ENR: Accelerated but conventional healing progression (inflammation, clotting, presence of pus, etc.)


  

  

  
• "Do you have regenerative abilities?"


  
• "Does your body heal itself back to its usual state, or just normal healing but faster?"


  
• "Are all parts of your body affected or just specific parts or systems?"


  

  PRIMARY OBJECTIVE: Support regeneration process

  

  
• Remove foreign objects (bullets, shrapnel, etc.) - regeneration will occur around them, causing recurrent damage


  
• Position patient to prevent template misalignment in major trauma


  
• DO NOT apply tourniquets unless bleeding exceeds regeneration rate


  
• Clear airway and ensure adequate breathing until respiratory system regenerates


  

  

  
• Administer D50W glucose solution for severe trauma (standard dose: 100mL)


  
• Apply thermal blanket to maintain body temperature


  
• For major injuries: Initiate superhuman nutritional protocol (SNP-R4)


  

  

  
• Vital signs every 5 minutes during active regeneration


  
• Watch for signs of regenerative shock: sudden hypotension, tachycardia, confusion


  
• Monitor for "template rebound" (over-regeneration)


  

  

  
• Most HTR patients can be treated on scene for non-life-threatening injuries


  
• Transport for: severe trauma exceeding 20% body surface, fully-penetrating injuries, head injuries with loss of consciousness, regenerative shock


  

  PRIMARY OBJECTIVE: Differential treatment of template vs. non-template systems

  

  
• Common template systems (in order of frequency):
  
    
  
  
    
  1. Skeletal (38%)
  
  
    
  2. Integumentary/skin (27%)
  
  
    
  3. Cardiovascular (15%)
  
  
    
  4. Nervous system (12%)
  
  
    
  5. Other/mixed (8%)
  
  
    
  
  
    


  

  

  
• Treat non-template systems according to standard protocols


  
• Protect template systems from iatrogenic damage


  
• Document boundary zones for hospital staff


  
• Prevent cross-system complications (e.g., regenerating bone damaging normal tissue)


  

  

  
• Skeletal LTRs: Allow bones to align naturally before stabilizing surrounding tissue


  
• Cardiovascular LTRs: Standard hemostasis for peripheral vessels, avoid intervention for core vasculature


  
• Skin LTRs: Apply antimicrobial shield to prevent regeneration over contaminants


  

  

  
• Transport ALL LTR patients to appropriate trauma centers


  
• Alert receiving facility of specific systems affected


  
• Segregate and label template vs. non-template injuries


  

  PRIMARY OBJECTIVE: Ensure proper healing alignment before regeneration advances

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• Rapidly assess and correct anatomical alignment of ALL injuries


  
• Apply QuickSet? casts or splints for fractures (sets in 30 seconds)


  
• Close wounds with derma-approximators rather than standard sutures


  
• Irrigate wounds thoroughly before closure - infection risk remains high


  

  

  
• You have a limited window before malunion/improper healing occurs:
  
    
  
  
    
  • Mild ENR (5-10× normal rate): 60-120 minutes
  
  
    
  • Moderate ENR (11-30× normal rate): 10-59 minutes
  
  
    
  • Rapid ENR (31-100× normal rate): Generally under 10 minutes
  
  
    
  
  
    


  

  

  
• Continuous assessment of healing progression


  
• Watch for signs of improper alignment or adhesion formation


  
• Document healing rate for hospital records


  

  

  
• ENRs retain normal scarring patterns but at accelerated rates


  
• Infection risk remains significant despite accelerated healing


  
• Possibility of permanent functional impairment if alignment is not corrected BEFORE healing


  
• Many ENRs will require manual re-setting of improperly healed injuries.


  

  

  
• Signs: Sudden healing slowdown, pallor, cold extremities, confusion


  
• Action: Administer glucose solution, thermal management, protein supplement


  

  

  
• Signs: Pain at healing sites, discoloration, abnormal heat


  
• Action: Document and report to receiving facility, do not attempt to resolve in field


  

  

  
• Signs: Muscle spasms, altered consciousness during intense regeneration


  
• Action: Protect patient, position safely, do not chemically intervene unless status epilepticus


  

  

  
• Signs: Irregular healing patterns, right lower quadrant pain, healing stalls


  
• Action: Position patient on left side, support ABCs, expedite transport


  

  

  
• Templates may be unstable or developing


  
• Greater metabolic demands relative to body size


  
• Transport to pediatric facility with metahuman experience


  

  

  
• HTRs: May prioritize vital system healing over peripheral injuries


  
• LTRs: May experience system overload or boundary conflicts


  
• ENRs: At high risk for multiple improper healings if not rapidly addressed


  

  

  
• Pain perception often intact despite healing


  
• Regeneration can be traumatic experience even for experienced regenerators


  
• Standard pain control may be ineffective or unpredictably metabolized


  

  For all regenerative patients, document:

  

  
• Regenerator type and subtype if known


  
• Healing rate observed (use standard NSRA scale)


  
• Interventions performed and patient response


  
• Metabolic support provided


  
• Template conflicts or boundary issues observed


  
• Pre-transport healing status


  

  This protocol developed in conjunction with the NSRA Medical Division and the American College of Emergency Physicians

  Publication #MH-R743-2023 | Replaces #MH-R743-2021 | Required training: Module R27

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