Thanks for feedback. Many features weren't fully implemented because I had to release the game today instead of say next month. I'm working on the restart option in menu right now, so it will be in the first batch of fixes!
You can turn off the intro cutscene in TFtweaks entirely. As for other TFs, they are meant to be long. This is not Changed.
Medkits work different per creature because each creature is unique and gameplay is about discovering what works for them. I also don't know how you got it on "a" when by default using items is on "space" and "a" is for moving left.
There are keybinds in the game if that helps. Each grouo of keybinds has explanation in the settings, and also you see popups in the game all the time that tell you "E" to interact or "Space" to open the door thus explaining what they do. Though the system could use more clarity in places.
By red pouch I assume you mean ammunition? It's right next to the gun and is consumed upon shot. The gun is to the right of the first lever door.