D&D 5E D&D5e Dropping to 0 HP Alt Rules

Keaggan

Game Master
I'm making some adjustments to some rules to the game. How I do not want to implement them before I have a chance to get some feedback. I know there are many experienced D&D5e GMs in here so I'd like to hear from all of you. A Quick FYI, I run my games where the PCs can only get a long rest from specials Inns and short rests from 8 hours of sleep. Knowing that here are my alternative rule changes when someone drops to 0 HP.


0 HP & Healing

When you drop to 0 HP roll Death Saves as normal. However, now the numbers are split 1-10 fail & 11-20 succeed, making it a fair 50/50 chance. Nat 1 equals 2 fails, and a nat 20 equals 2 successes. You keep rolling once per round until you either have 3 successes or 3 failures. 3 successes without any outside help mean you are stable but won't wake up on your own for 1d4 hours. 3 failures, and you find yourself in the long dark. Perhaps you can be awakened again….?


Lasting Effects: If you are wake up through healing, successful saves, or brought back with Revivify, the toll on your body is lasting. For every round, you are down, including the first one that you dropped to 0 HP roll 2d6. The first d6 will determine which attribute, and the second d6 is how much that attribute has been reduced. Every 8 hours of rest, you gain back 1 point. Long rest will restore 2 points. Ex. You roll 2d6 and get [2] [4]. Your Dexterity would be lowered by 4. This means if you are downed for 3 rounds, you will roll 2d6 3 times. The same attribute may be lowered multiple times.

Magical Healing: If you cast a spell or use a magic healing potion on someone that was downed, they get advantage on their Death Save. If they succeed, they get 1HP and wake up. If they fail, the death spiral continues.

Healer's Kit: You may attempt to assist someone downed with a Healer's Kit. Roll a Medicine check DC 10. A success gives them advantage on their Death Save. A failure does nothing. The Healer's Kit is used up when the target no longer is rolling Death Saves.
 

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Stalker0

Legend
For some really gritty play this seems fine enough, certainly no player will ever want to get close to 0 hps with such a system. Although its more granule than normal for 5e. You might consider just using the Exhaustion system for such a thing, as ability increases/decreases were removed from general play due to the need to retweak all stats.

Exhaustion could be better or worse for a person compared to your system depending on how the die falls.

Another option if you want to be a little kinder to the player, is do the 2d6 (or exhaustion) only on a failed death save. So if they succeed on a round they don't take the penalty, on a failure they take the penalty, and of course on that 1 they take double the hit!

So confirming that a healer's kit only stabalizes them and cannot bring them to 1 hp like magical healing, correct?
 

Li Shenron

Legend
I like this house-rule a lot. It is not complicated and it serves its purpose of encouraging players to avoid dropping to 0 as much as possible, and eliminates the feeling of coming back fully capable after healing for those who don't like that.

I would try it first with a single 2d6 roll rather than one roll per each round unconscious just to be on the safer side.


ability increases/decreases were removed from general play due to the need to retweak all stats.

This is true but it's also a design mistake*. 5e does not require to pre-calculate all stats on your character sheets. I've been playing with my kids since they were 6yo using my custom character sheets WITHOUT skills and ST scores and there is no problem. We do have precalculated attacks but even there we could live without. Because of this, 5e is THE best edition ever to support ability scores damage if you want.

* or rather a designers' shortsightedness
 
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I strongly urge keeping the "20 on a death save restores 1 HP". Rolling a nat 20 and being able to rejoin the combat immediately when you thought you were dying makes for some very exciting moments.
 

Dragonsbane

Proud Grognard
We use the following to help with 5E HP issues:

When you drop to 0 hp, you gain a level of exhaustion, even if you are brought right back up with spells or other means. This only goes away after a long rest, and only one level per long rest.
When you long rest, you get 1hp/lv back, nothing more. You gain only 1 hit dice as well.
Death save failures accumulate until a long rest.

I remember the moment a new player said "Wow I haven't had a cleric I play ever cast a healing spell" and I felt all warm inside.

Let the up and down of getting knocked out begone! Begone video-gamey full hp back after long rest!
 

Quartz

Hero
Ask yourself this question: faced with such penalties, why would I want to play a frontline PC? Your system disadvantages the front line considerably. An unlucky hit can take anyone down and then you're out for at least 3 rounds without outside intervention and even if you do get help you're still in trouble. That way lies a death spiral. And it's unfun for the player of the the frontline PC.

Getting up after being knocked down is not a problem IMHO. The first time. Think of it as a boxing match. Many boxers get knocked down once only to go on to win, but boxers who get knocked down multiple times seldom go on to win. If you persist with this you might want to add a class feature to the frontline types to negate the first knockdown. Something like

Grit: when you are reduced to 0 HP but not killed outright you may move a maximum of 10' but lose any unspent Actions, Bonus Actions, and Reactions and you start the following round with HP equal to your Proficiency Bonus plus your current HD. Once you use this ability you may not use it again until you have finished a Short Rest or a Long Rest.

Or you could repurpose Action Surge.
 

NotAYakk

Legend
We use the following to help with 5E HP issues:

When you drop to 0 hp, you gain a level of exhaustion, even if you are brought right back up with spells or other means. This only goes away after a long rest, and only one level per long rest.
When you long rest, you get 1hp/lv back, nothing more. You gain only 1 hit dice as well.
Death save failures accumulate until a long rest.

I remember the moment a new player said "Wow I haven't had a cleric I play ever cast a healing spell" and I felt all warm inside.

Let the up and down of getting knocked out begone! Begone video-gamey full hp back after long rest!
In 5e, a beefy tank character adds to the group's ability to take hits over a day.

In your rules, they are nothing but a small buffer on healing magic.

A cleric or paladin makes a ridiculously better tank than a fighter. For any given party, adding a Fighter adds less ability to deal with monster hits than adding a Paladin, which is less than adding a Cleric.

Bearbarians remain not that bad, due to resistance doubling healing magic. But only after you have at least 1 strong healer, maybe 2; 2xsmall is small, and 2x1 (double effectiveness, 1 healer) is no better than 1x2 (single effectiveness, 2 healers), and Barbarians lower AC means they aren't quite twice as easy to heal (as they get hit more for a given number of attacks).

... Have you considered just going to gritty rests?

(a) When it takes a week to regain your HP, you don't get better after an overnight.
(b) Overnight sleeps don't recover your HD, so healing is even slower than your model.
(c) Spell based healing isn't infinitely better than having a tough PC, but remains strong. It just isn't an infinite flow.
(d) Higher level characters don't take longer to heal up than low level characters.

You can also mix this with stuff that makes healing a bit better to encourage its use. Like: Exhaustion on going to 0 HP, you can expend a HD to boost a magical healing effect, cure wounds uses the higher of d8 or the target's expended HD.

You could also allow Exhaustion recovery on an overnight at the cost of a HD (trust me, that gets expensive).
 

Asisreo

Patron Badass
Something I don't think many people have actually considered is, what I think, is a simple solution.

No death saves, no penalties, when you drop to 0 HP, that's instant death.

The catch is to double the HP of all player characters. Yes, this leads to some massive HP pools, especially at later levels, but healing is still widely inefficient and while they may be able to take more damage, they actually get fearful when they approach low HP. Some healing-focused characters would need to be proactive with their heals and maybe spend stronger slots to give a more meaty buffer between life and death.

If doubling seems too much, you could go the extra effort of either multiplying by 1.5 instead (more math) or just reducing the practical AC of most characters (more design tweaking).
 

Dragonsbane

Proud Grognard
In 5e, a beefy tank character adds to the group's ability to take hits over a day.

In your rules, they are nothing but a small buffer on healing magic.

A cleric or paladin makes a ridiculously better tank than a fighter. For any given party, adding a Fighter adds less ability to deal with monster hits than adding a Paladin, which is less than adding a Cleric.

Bearbarians remain not that bad, due to resistance doubling healing magic. But only after you have at least 1 strong healer, maybe 2; 2xsmall is small, and 2x1 (double effectiveness, 1 healer) is no better than 1x2 (single effectiveness, 2 healers), and Barbarians lower AC means they aren't quite twice as easy to heal (as they get hit more for a given number of attacks).

... Have you considered just going to gritty rests?

(a) When it takes a week to regain your HP, you don't get better after an overnight.
(b) Overnight sleeps don't recover your HD, so healing is even slower than your model.
(c) Spell based healing isn't infinitely better than having a tough PC, but remains strong. It just isn't an infinite flow.
(d) Higher level characters don't take longer to heal up than low level characters.

You can also mix this with stuff that makes healing a bit better to encourage its use. Like: Exhaustion on going to 0 HP, you can expend a HD to boost a magical healing effect, cure wounds uses the higher of d8 or the target's expended HD.

You could also allow Exhaustion recovery on an overnight at the cost of a HD (trust me, that gets expensive).
These are interesting suggestions! I might try them next time we play 5e, right now I am about to start Ghosts of Saltmarsh using Cypher System instead of 5e, they don't use hp :) We just finished Lost Mine of Phandelver, it was a blast, no effort to convert to Cypher on the fly, and my players were thrilled with the change.
 

werecorpse

Adventurer
My rules are:
Characters unconscious at 0 hp but Hp go to -10 (this reduces the yo yo effect as if you are at -10 it takes not insubstantial healing to be returned to 1hp).
Death saves rules are unchanged, rolling a 20 brings you to 1 hp regardless of what you were in when you rolled it. Also even if you are stabilised below 1hp with magical healing or some such you still get to roll until you get 3 successes or failures (That rolling a 20 on a death save at a critical time causes more shouts of celebration at my table than any other).
Each failed death save (as well as each critical hit sustained) increases your chance of sustaining a lingering injury. However this is rolled for after a long rest (so it both doesn’t have an immediate mechanical effect on the combat and is something the players wish to avoid).
 

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