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D&D 5E "Combat exhaustion" at 0 hp?

toucanbuzz

Legend
I know the topic of replacing Death Saves has been covered, but I wanted to take a version I've seen on other threads and weave it into my own (vitality at 0hp). Not looking for debate on whether one should use an alternative to Death Saves, but any abuses or loopholes you could see occurring. My players currently like the idea of being relevant, albeit reduced in ability and hovering at death's door, at 0hp.

Several DMs use some version of a homebrew rule, in lieu of Death Saves at 0 hit points, of: gain 1 level of exhaustion. The purpose is largely to avoid "whack-a-mole." The rule has been criticized as easily leading to a death spiral, especially for front-line characters, though it is a simplistic rule to implement. What if the exhaustion gained this way were easier to shed? Much credit to folks in this thread and @6ENow!

Proposed System:
  1. At 0 hit points, PC gains 1 level of "combat exhaustion" and any concentration effects end. Combat exhaustion is the same as normal exhaustion and stacks with it, but is easier to remove by:
    • 1 per short rest or lesser restoration
    • All by a long rest, greater restoration, or potion of vitality.
  2. The PC makes a Concentration saving throw to gain the "staggered" condition and stay conscious. Failure means the character gains the "unconscious" condition. Once a player gains at least 1 hit point, they lose these conditions. A player can voluntarily "fail" the save (perhaps to avoid looking like a threat on the battlefield).
    • If the save is failed by 5 or more, the PC gains a "lingering injury" per the DMG p272.
  3. A "staggered" PC loses reactions, cannot move unless they use the Dash action, and can only take a single Action or Bonus action on their turn. Each time the PC takes damage while staggered, they must make another Concentration saving throw as above.
    • Option A: any subsequent damage to a staggered or unconscious PC is taken from their Vitality points. At 0 Vitality, the PC is dead, unless the enemy opts to knock them out with an otherwise fatal melee attack, leaving the PC with 1 vitality and the unconscious condition.
      • Vitality = starting HP, only changing if the CON modifier changes.
      • Vitality heals at the rate of 1 per Long Rest. It can be magically healed if the character is already at full hit points, and then at the rate of 1 for every 10 points of healing. Regeneration is the exception, always heals at least 1 per tic.
    • OR, thinking Option B: any subsequent hits imposes 1 combat exhaustion; a critical hit imposes 2. The enemy can opt to knock them out with an otherwise fatal melee attack (one that would give them 6 exhaustion levels), leaving the PC with 5 levels of normal exhaustion (all combat exhaustion is now converted to normal exhaustion).
Option A is our current system and can make for more brutal games akin to 3rd edition and AD&D. One direct hit by a giant's club can, and should end you, whether you're 1st or 20th level. But, you might survive a swipe of a sword. The 20th level character has gotten better at avoiding these types of fatal hits, which is why they have more "hit points." Getting Vitality back can take much time, reflecting the reality of taking "real damage."

Option B is slightly more forgiving because no matter what the damage is, whether it be a 1 point needle prick from a faerie or a 50 point dragon claw, you effectively "avoid" the fatal blow and instead creep closer through the Exhaustion mechanic and become much more useless in combat. However, I got away from Death Saves for this exact reason that at 0 hp, damage becomes absurdly irrelevant. A 200 damage "hit" is treated just the same as a 1 damage "hit" and that doesn't feel right (for me...stress, for me and my games).
 

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Don't do it is my advice.

Imposing exhaustion on PCs who drop to 0HP encourages the 5MWD. It effectively mandates it.

It also has minimal impact on spellcasters, while smashing Martials (by penalizing ability checks and attack rolls, which spellcasters tend to avoid).

All you'll see as an end result is nova strikes and class imbalance as the PCs look to long rest up after every single encounter.
 

I've been running D&D 5e with exhaustion at 0hp in my WoG/ToEE campaign for years, and ditching a dungeon after 5 minutes is definitely not a good idea. It works fine. Players heal earlier rather than later and play more defensively overall. It's not until your 3rd level of exhaustion that it becomes a serious problem. I like this Combat Exhaustion idea, though, it's a little more forgiving.

The Massive Damage optional rules in the DMG are also an option, though having them go away with magical healing makes them pointless.
 

guachi

Adventurer
I have +1 exhaustion level at zero HP and it's never led to a 5MWD. It's led to players using their HD sooner rather than later. The most levels of exhaustion I've ever had was probably three levels, though it may have only been two on several occasions.

What it did do was lead to players roleplaying their conditions, and that was fun. It also led to a greater sense of accomplishment. Like the players actually suffered a bit for their success.
 

I've never seen Exhaustion death happen, ever. Someone did actually get to level 5 once, but at that point, you are physically incapable of adventuring any more. His buddies carried him home.
 

Blue

Ravenous Bugblatter Beast of Traal
1. A role in the party, tank/front line melee, is more likely to get attacked because they intentionally put themselves between foes and the other party members. Because combat can be swingy, with a couple of unfortunate crits against you or a failed saves they will go down. Here we have someone more likely to be penalized for playing al altruistic role where they defend others. That is against the style of play I want to engender.

2. Is it their fault for going down, a healer's fault for not proactively healing them, a caster's fault for not buffing them or defbuffing/action denial on an enemy? D&D is a team game, yet the penalty is getting assigned most often to certain roles. This penalizes the wrong character often, or puts a team penalty on only one.

3. The first level of exhaustion gives disadvantage on all ability checks. While there are some ability checks in combat, ability checks are by far the predominant way to mechanically interact with the other pillars of play besides combat. So the penalty for getting dropped in combat is to suck mechanically at everything that is not combat. So the penalty is completely inappropriate for what happened.

So in the end you have penalizing the wrong character, penalizing them for playing with a play style where they enhance the team, and the penalty is of the wrong type for combat.

You need to fix all three to even have a rule that isn't wildly bad. For example, making a new track besides exhaustion that has combat penalties, or reworking the penalties from exhausion so the first level or two primarily affects combat would resolve the third. People just pick exhaustion because it exists.

Once all three of these have been fixed, then you have a rule you can compare to the current rule and see if it is better.
 

1. A role in the party, tank/front line melee, is more likely to get attacked because they intentionally put themselves between foes and the other party members. Because combat can be swingy, with a couple of unfortunate crits against you or a failed saves they will go down. Here we have someone more likely to be penalized for playing al altruistic role where they defend others. That is against the style of play I want to engender.

2. Is it their fault for going down, a healer's fault for not proactively healing them, a caster's fault for not buffing them or defbuffing/action denial on an enemy? D&D is a team game, yet the penalty is getting assigned most often to certain roles. This penalizes the wrong character often, or puts a team penalty on only one.

3. The first level of exhaustion gives disadvantage on all ability checks. While there are some ability checks in combat, ability checks are by far the predominant way to mechanically interact with the other pillars of play besides combat. So the penalty for getting dropped in combat is to suck mechanically at everything that is not combat. So the penalty is completely inappropriate for what happened.

So in the end you have penalizing the wrong character, penalizing them for playing with a play style where they enhance the team, and the penalty is of the wrong type for combat.

You need to fix all three to even have a rule that isn't wildly bad. For example, making a new track besides exhaustion that has combat penalties, or reworking the penalties from exhausion so the first level or two primarily affects combat would resolve the third. People just pick exhaustion because it exists.

Once all three of these have been fixed, then you have a rule you can compare to the current rule and see if it is better.

And after ability checks comes attack rolls.

So you penalise the fighter... for fighting.

And the Rogue gets.. no more sneak attack.

How many Wizards give a naughty word about disadvantage on attack rolls or ability checks? Or really any of the exhaustion effects? They're still casting just fine with 5 levels as they were with none.

Its just a bad idea for mine and it disincentives rhe exact kind of play I want to encourage, while punishing some classes overly harshly for doing nothing else than their job.
 

DND_Reborn

I don't debate opinions.
@toucanbuzz

Thanks for the props! I don't have time to review your post but I will make time tomorrow. At a quick glance, it does seem (nearly) identical to systems I've used in the past so I am very hopeful you can nail down a variant you like. Until later! :)

EDIT: Ignore the doubters man, these types of systems work great IMO and IME. ;)
 

werecorpse

Adventurer
The method I use to discourage blasé response to dropping to 0 behind having monsters gnaw on the unconscious character is
1. every failed death save gives a chance of getting a lingering injury; but
2. you don’t roll for the lingering injury chance until you take a long rest.

The lingering injuries are things like lose 10’ of movement, disadvantage on strength ability checks, max HP reduced etc. They aren’t totally debilitating but are annoying. They can add up and take weeks of rest (or the regenerate spell - so they can drop out of the game at 13+ level) to recover from.

The fiction is that during the adventuring day your Adrenalin keeps you going but when you wake the next morning you are sore and sorry.

The in game affect is that players work to avoid a risk of a failed death save and the impact of the same isn’t a death spiral - plus they know if they’ve built up a few they don’t want to long rest unless they have to because they may get an Injury so they discourage the 5mwd.
 


I keep seeing this 'blase about hitting 0 hp' concern.

Why would players be blase about it? It sucks when it happens as you not only start missing turns but youre also bleeding out.

Plus things like AOEs suck bad as you auto fail Str and Dex saves when incapacitated (which is likely to kill most downed PCs) also inflicting a failed death save, and any melee damage you take is a crit and 2 failed saves.

I certainly don't see Players being blase about low hit points.
 

Quartz

Hero
Several DMs use some version of a homebrew rule, in lieu of Death Saves at 0 hit points, of: gain 1 level of exhaustion.

I like the idea of this but not the implementation. As others have noted, it prevents combat PCs from performing their shtick. It's not much fun for the player to have their PC taken out by a lucky hit on the first round and then be penalised for the rest of the adventure.
 

vincegetorix

Jewel of the North
How about losing 1 HD roll in current and max hp until your next long rest? So at level 1, most character can still bear to fall to 0 hp at least 2 times between long rests.
 

I keep seeing this 'blase about hitting 0 hp' concern.

Why would players be blase about it? It sucks when it happens as you not only start missing turns but youre also bleeding out.

Because they read online that it's "optimal" to reserve any healing for 0 hp, because at that point, the amount of monster-inflicted damage negated is maximized. Whack-a-mole with Healing Word isn't particularly uncommon.
 

embee

Lawyer by day. Rules lawyer by night.
I keep seeing this 'blase about hitting 0 hp' concern.

Why would players be blase about it? It sucks when it happens as you not only start missing turns but youre also bleeding out.

Plus things like AOEs suck bad as you auto fail Str and Dex saves when incapacitated (which is likely to kill most downed PCs) also inflicting a failed death save, and any melee damage you take is a crit and 2 failed saves.

I certainly don't see Players being blase about low hit points.
My players are not blase about hitting 0. They fear hitting 0. Because of what it does to the playing field. My encounters generally are set up to avoid surround-and-pound. The players are usually outnumbered for the bulk of the battle.

If one of them goes down, then another one has to break off to stabilize them. It's not just that the fighter went down and now they're down 1 attack that round. The fighter went down. And now someone might have to get them out of harm's way and heal them. Someone might have to break off from their attack on their own monster to go hit that other monster so that it doesn't try to hit the fighter again. It's not just one attack gone. It's sometimes two or three.

Then again, I also play with negative HP. So a PC with 6hp who takes 12dmg is at -6hp, not 0hp. A healing spell may not get them back to 1hp.
 

Because they read online that it's "optimal" to reserve any healing for 0 hp, because at that point, the amount of monster-inflicted damage negated is maximized. Whack-a-mole with Healing Word isn't particularly uncommon.

Well then they're utter idiots.

Healing word chews up a spell slot, and a bonus action (and being a bonus action spell, it negates the ability of the caster to cast another spell that turn), and only heals you (you remain prone).

As for the person dropped to zero, you get to spend an entire round prone and incapacitated and easy prey for a coup de grace or getting nuked in a AoE or similar (plus losing your actions).

Entering encounters on anything less than full HP is suicide.

The only time I see 'whack a mole' is when an encounter gets a little too deadly and PCs start to drop, and get stuck in a 'healing loop'.

It's just a non issue, and if it WAS an issue the last thing I would be doing would be implementing a rule that a) overly penalizes martial PCs, and b) mandates the 5MWD.

If you must have some kind of rule, I'd simply bring in a rule that after your first failed death save of the day, the remainder are at disadvantage until you take a long rest.

IMG I did increase the DC to a 15 Con ability check to make it a bit harder to pass, and bring Con into it a bit more.
 

DEFCON 1

Legend
I have done the "replace the 3 Death Saves" for the Exhaustion table before. When I did it though, I re-ordered the Exhaustion table because I found having disadvantage on ability checks at level 1 to be way too penalizing for the rest of the adventuring day. Getting Exhaustion should make you think twice about getting into more fights... not having everything else you do be where your problems lie. So my table looked like this:

Level 1: Movement speed halved
Level 2: Hit Point Maximum halved
Level 3: Disadvantage on attack rolls, saving throws, and STR ability checks
Level 4: Disadvantage on all other ability checks
Level 5: Movement speed zero
Level 6: Death

It put the most easily worked-around penalty first. Moving half speed just means out of combat you have to use your action to Dash in order to keep up with everyone, while the others can scout, forage, map etc. while moving. Then halving your HP maximum is painful... but your combat ability is not yet lessened so you can still fight normally if you have to... but it does put more pressure on you and your allies to manage who is getting hit and where your healers are.

Then once you get to Level 3 you pretty much shouldn't be fighting at all. And as probably is obvious... I put STR ability checks in with attacks and saves because most STR checks involve in-combat action with grappling, shoving and such, and I felt all actions you take in combat should be at disadvantage. It does mean that swimming, climbing and jumping get penalized before all other ability checks... but I was fine with that. After that, your out-of-combat activities get destroyed... and then you are helpless and then dead (like the normal Exhaustion chart.)

I found this chart to be much more manageable, and the players had no issue with it. I did have some other extra rules on recovery from Exhaustion-- a long rest to lose one level... and if you had someone attending to you over the long rest you lost two (although that individual did not gain the effects of a long rest if they spent the eight hours nursing you to health.)

Best of luck with however you decide to run it!
 

DND_Reborn

I don't debate opinions.
Proposed System:
  1. At 0 hit points, PC gains 1 level of "combat exhaustion" and any concentration effects end. Combat exhaustion is the same as normal exhaustion and stacks with it, but is easier to remove by:
    • 1 per short rest or lesser restoration
    • All by a long rest, greater restoration, or potion of vitality.
  2. The PC makes a Concentration saving throw to gain the "staggered" condition and stay conscious. Failure means the character gains the "unconscious" condition. Once a player gains at least 1 hit point, they lose these conditions. A player can voluntarily "fail" the save (perhaps to avoid looking like a threat on the battlefield).
    • If the save is failed by 5 or more, the PC gains a "lingering injury" per the DMG p272.
  3. A "staggered" PC loses reactions, cannot move unless they use the Dash action, and can only take a single Action or Bonus action on their turn. Each time the PC takes damage while staggered, they must make another Concentration saving throw as above.
    • Option A:any subsequent damage to a staggered or unconscious PC is taken from their Vitality points. At 0 Vitality, the PC is dead, unless the enemy opts to knock them out with an otherwise fatal melee attack, leaving the PC with 1 vitality and the unconscious condition.
      • Vitality = starting HP, only changing if the CON modifier changes.
      • Vitality heals at the rate of 1 per Long Rest. It can be magically healed if the character is already at full hit points, and then at the rate of 1 for every 10 points of healing. Regeneration is the exception, always heals at least 1 per tic.
    • OR, thinking Option B: any subsequent hits imposes 1 combat exhaustion; a critical hit imposes 2. The enemy can opt to knock them out with an otherwise fatal melee attack (one that would give them 6 exhaustion levels), leaving the PC with 5 levels of normal exhaustion (all combat exhaustion is now converted to normal exhaustion).
Hey @toucanbuzz I've got some more time so I'll review it in detail.

1. Looks great.

An option you might want to consider is what we just started: your "combat exhaustion" starts at level 6 (unconscious, not dead). If you are healed, your level immediately becomes 6 - your CON modifier. At the end of each successive turn, your level decreases until it is gone.

Ex. CON 14 (typical IME) would be unconscious, after being healed to 1 hp (or more), you would be at 4 (6-2) levels of "combat exhaustion". In other words: you have half max HP, disadvantage on attacks/saves, half speed, and disadvantage on ability checks.

At the end of your next turn, your max HP would be normal.
At the end of the next turn, you no longer have disadvantage on attacks/saves.
And so on, until all effects are gone (4 rounds later, in this case).

This means any "combat exhaustion" will be gone shortly after the battle is over. You won't have to worry about recovering it later, or house-ruling spells to remove it, etc. If you have normal exhaustion, that is still in effect even after your combat exhaustion reaches that level or better.

2. What DC are you using for the CON save? We make it the same as a Concentration Check (DC 10 or half damage, whichever is higher).

3. Starting HP for Vitality is good. We've used that, and also just your CON score, which is our current default. Another option is to tie in levels of exhaustion with it. So, your Vitality (we use the term "Wound Points" from SW d20) would equal 5 + your CON modifier.

In your system, I think this would translate into additional damage granting levels of exhaustion, which can get pretty brutal LOL!

Magical healing restores 1 Vitality (Wound Point) per spell level. So, a Heal would restore 6 points, and a level 1 Cure Wounds would be 1 point, etc.

While "Wounded" (i.e. no HP) or "Staggered" (your term) I like the only action or bonus action--using Dash as a move simplifies things, too.

There are lots of ways to do all this so if it works as you have it and your table likes it, I'm glad for any help I was able to offer. I am currently compiling an extended house-rules document with whatever current version we settle on. I'll probably post a thread on it in the next week or so. Anyway, good work and I hope it works out for you! :)
 

DEFCON 1

Legend
Well then they're utter idiots.

Healing word chews up a spell slot, and a bonus action (and being a bonus action spell, it negates the ability of the caster to cast another spell that turn), and only heals you (you remain prone).

As for the person dropped to zero, you get to spend an entire round prone and incapacitated and easy prey for a coup de grace or getting nuked in a AoE or similar (plus losing your actions).

Entering encounters on anything less than full HP is suicide.

The only time I see 'whack a mole' is when an encounter gets a little too deadly and PCs start to drop, and get stuck in a 'healing loop'.

It's just a non issue, and if it WAS an issue the last thing I would be doing would be implementing a rule that a) overly penalizes martial PCs, and b) mandates the 5MWD.

If you must have some kind of rule, I'd simply bring in a rule that after your first failed death save of the day, the remainder are at disadvantage until you take a long rest.

IMG I did increase the DC to a 15 Con ability check to make it a bit harder to pass, and bring Con into it a bit more.
You know... there's always the possibility that all the other tables don't run combat the way yours does. So all of these points you are stating like they were facts might not actually be true for anybody else.

So claiming these ideas are not necessary is rather kind of pointless.
 

DND_Reborn

I don't debate opinions.
How about losing 1 HD roll in current and max hp until your next long rest? So at level 1, most character can still bear to fall to 0 hp at least 2 times between long rests.
This is nice, it works in to one of my house-rules about spending HD. If you go to 0 HP, you can spend a HD to offset the damage, possibly keeping you above 0 hp (and thus in the fight).
 

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