D&D 5E Falling below zero HP and Exhaustion mechanic

[Spohedus]

I have long been bothered by the whack-a-mole nature of falling below zero HP in 5th edition for many of the same reasons that have been discussed on this forum for five years. Here's my question: has anyone tried a house rule to utilize the exhaustion mechanic? Here's an example I'm considering:

When you become conscious after falling to zero HP, you have five levels of Exhaustion. You may roll a Constitution saving throw at the end of each of your turns to remove a level of exhaustion until you only have one level of exhaustion more than the level of exhaustion you had before falling to zero HP. Finishing a long rest removes one level of exhaustion, provided that you also ingest some food and drink.

Please let me know your thoughts, and especially any experience you've had with this option.

 

[Shiroiken]

The primary problem with using Exhaustion is that it's nearly impossible to get rid of without taking 1 or more Long Rests. This means that any time a party member drops to 0 HP, the adventuring day is usually done. If the wack-a-mole problem is an issue for you, you can have characters that recover HP remain unconscious until someone takes an action to wake them or they take damage (and somehow remain above 0 HP).

 

[DND_Reborn]

Yeah, the whack-a-mole issue is an issue for many tables. We use exhaustion as well and got rid of death saves in the process.

Our house-rule is

When you reach 0 HP you fall unconscious for 1d4 hours and suffer a level of exhaustion. You can make a Constitution check (NOT A SAVE) with a DC equal to 10 or half the damage taken (similar to a spell concentration check) to avoid the level of exhaustion.

If you take damage while unconscious, you automatically suffer a level of exhaustion. If you take damage during the round in total of your maximum HP, you die.

If your receive healing and your HP is increased to 1 or higher, you remain unconscious. A Lesser Restortation spell will restore you to consciousness, as will a DC 20 Wisdom (Medicine) check and the use of a Healer's Kit. You also regain consciousness if you are healed to your maximum HP.

You die if you accumulate six levels of exhaustion (as normal) or if you suffer damage sufficient to exceed your maximum HP (also normal rule).

We also use the lingering injury rules in the DMG and massive damage rules in there as well.

As to your idea, it is sort of the reverse, huh? Starting at five levels of exhaustion and possible recovering some through CON saves. Oh, and what is the DC for the CON save? You don't say.

Just to make sure I have it right let's do an example. I am going to refer to a level of exhaustion as 1 EL (1 exhaustion level). So, five levels of exhaustion would be 5 EL.

I have no exhaustion (0 EL) and fall to 0 HP. I am at 5 EL (near dead) at this point. I make CON saves each round until I am at 1 EL. I am healed up to full HP but still have 1EL. Later on, I go to 0 HP again. I am at 5 EL again, but this time I can only recover to 2 EL (one worse than before). Finally, we return to town and I gain rest, requiring two long rests to remove the 2 EL.

I think it might work fine. Personally, going in the other direction could work as well and is the approach I would try, but that is only a matter of preference.

If you don't mind the gritty feel of the game, I would try it. I think going to 0 HP SHOULD be a very drastic thing and in 5E, it just usually isn't.

 

[tetrasodium]

I tried the injuries mechanic in moregraves misc140, but got massive pushback from dndbeyond's complete inability to handle it (much like everything else) and eventually had to drop it because I expected my plsyers to trak their own injuries instead of the g both tracking & constantly reminding them. In the end I went with persistent death saves & fate points from darker dungeons

In a nutshell, a long rest clears only one death save. Everyone starts with one fate point & the group can get a fate point for doing especially heroic stuff, but they need to decide who gets that one point. Spending a fate point allows a PC who by all rights should be dead to survive like comic/action movie heroes... everyone thought john was dead from that fireball & yea he's having a terrible day, but he was just mostly dead & managed to survive.

Also in there is a "fatigue" mechanic that is somewhere between stun/shaken & exhaustion that works pretty well. Unfortunately ddb doesn't even support the optional phb/dmg mechanics so good luck if your players are attached to it.

 

[Don Durito]

I made an alternative exhaustion mechanic here which is not so punishing the party can't continue on.

But really part of the issue is only recovering one level per long rest. This just seems like the wrong end of the stick. Everything else recovers on a long rest, so should exhaustion. If you want to be able to make attrition work across more than one day you need to make it harder to long rest anyway.

If your long rests take a week, or can only take place in civilisation, then you can still have exhaustion as a threat during wilderness adventures.

But there's an inherent tension at work here. It seems the issue with whack-a-mole is that it makes injury feel trivial. Once you start making exhaustion apply the issue is it doesn't. So the party will want to long rest - but if you want the injury to feel real - then they probably should!

 

[Doc_Klueless]

I use the common houserule of One Level of Exhaustion each time a PC dips below 0 HP. I've seldom had a PC drop below 0 HP more than once per encounter.

The first level of Exhaustion isn't really that punishing (Disadvantage on Ability Checks) if people remember that Attack rolls and Saving Throws are NOT Ability Checks (per Sage Advice). It's also why Level Three calls out Attack Rolls and Saving Throws.

Are attack rolls and saving throws basically specialized ability checks?
They aren’t. It’s easy to mistake the three rolls as three faces of the same thing, because they each involve rolling a d20, adding any modifiers, and comparing the total to a Difficulty Class, and they’re all subject to advantage and disadvantage. In short, they share the same procedure for determining success or failure.

Despite this common procedure, the three rolls are separate from each other. If something in the game, like the guidance spell, affects one of them, the other two aren’t affected unless the rules specifically say so.

The primary problem with using Exhaustion is that it's nearly impossible to get rid of without taking 1 or more Long Rests. This means that any time a party member drops to 0 HP, the adventuring day is usually done.

Yeah. It's definitely a play-style that might not mesh with everyone. We like it, but we can be weird. Heh.

Also:

It had me come up with Vitality Potions that cure levels of Exhaustion (basic 1d4, Greater 1d4+1, Superior 1d4+2, Supreme 1d4+3). They're expensive though.

Greater Restoration can also remove a level of Exhaustion per the rules. We've house ruled that Healing Domain Clerics add +1 level of Exhaustion removed for each of the Restoration spells.

We've also kinda houseruled sorta that the better accommodations you stay in remove increased levels of Exhaustion up to 3 levels per night. So Squalid & Poor (camping tents, sleeping rolls out in the open, etc. fall in here) removes 1 level, Modest and Comfortable (Tiny Hut falls in here) removes 2 levels, Wealthy & Aristocratic (Magnificent Mansion is in here) removes 3 levels.

 

[GlassJaw]

@Doc_Klueless I like your additional ways of removing exhaustion.

 

[Doc_Klueless]

@Doc_Klueless I like your additional ways of removing exhaustion.

Thanks!

 

[GlassJaw]

Thanks!

Although on second read, I would reduce the number of exhaustion levels for those potions since there are only 5 levels. Not sure the random roll is adding much gameplay either. Just have each potion remove 1 level of exhaustion as the quality of option improves: 1, 2, 3, 4 for Basic to Supreme.

 

[Doc_Klueless]

Although on second read, I would reduce the number of exhaustion levels for those potions since there are only 5 levels. Not sure the random roll is adding much gameplay either. Just have each potion remove 1 level of exhaustion as the quality of option improves: 1, 2, 3, 4 for Basic to Supreme.

It's just to sorta kinda mimic Healing Potions. The randomness doesn't serve any other purpose.

Like I said: We're kinda weird.



But your idea would also work great!

You DID get me thinking, though. I think next time we play, I'll float: Basic 1d4-2 , Greater 1d4-1, Superior 1d4, Supreme 1d4+1. Minimum 1 level. I suspect, though, that we'll keep it the same as it just works for us.