D&D 5E Death Saves & Pop-Up Healing

[overgeeked]

I don’t think one level of exhaustion when you drop to 0 would create too much of a death spiral. A bit of one, yes, but that’s the aim of such a house rule.

It depends on how many times you're dropped to zero. One isn't that big of a deal...except the disadvantage on ability checks you now have. Saving throws are ability checks as are attacks. One more and it's half movement. That's deadly in combat. I don't like the death spiral aspect, but I do like the idea of staying in bed a few days to clear the exhaustion levels. Like after the adrenaline clears, then you're exhausted.

 

[Charlaquin]

It depends on how many times you're dropped to zero. One isn't that big of a deal...except the disadvantage on ability checks you now have. Saving throws are ability checks as are attacks.

No, they’re considered different types of rolls by the rules. The third level of exhaustion would be redundant otherwise.

One more and it's half movement. That's deadly in combat.

Yeah, the idea is that once a member of your party has taken one level of exhaustion, it’s time to get them to safety to rest it off ASAP, and you avoid combat if at all possible on the way there.

I don't like the death spiral aspect, but I do like the idea of staying in bed a few days to clear the exhaustion levels. Like after the adrenaline clears, then you're exhausted.

Fair enough. I’m just saying, if one was to use an exhaustion-at-0-HP house rule, the death spiral would be part of the point. You just don’t want it to be so death spirally that character death is basically inevitable from the very start of the spiral.

 

[overgeeked]

No, they’re considered different types of rolls by the rules. The third level of exhaustion would be redundant otherwise.

Yeah, the idea is that once a member of your party has taken one level of exhaustion, it’s time to get them to safety to rest it off ASAP, and you avoid combat if at all possible on the way there.

Fair enough. I’m just saying, if one was to use an exhaustion-at-0-HP house rule, the death spiral would be part of the point. You just don’t want it to be so death spirally that character death is basically inevitable from the very start of the spiral.

Kinda. Because it’s too easy to start down that dark path. I’m a fan of old school games and WFRP so it’s not instant death, dismemberment, or permanent injury I take issue with. I’m perfectly fine with the possibility of character death. It seems a bit much that it’s practically guaranteed with that rule.

 

[mrpopstar]

Exhaustion is no joke. We lost a character to exhaustion, and I've seen it involved in other character deaths.

 

[mrpopstar]

It's a perennial problem with 5E. There's no lasting consequences of nearly dying. There's a lot of interesting house rules to solve the problem. This might just be one more to add to the pile, but I think it works well and solves a few problems without drastically changing much. There are changes to RAW, yes, but they're minor, I think. And the changes happen to solve a lot of related issues, I think.

So here goes...

Hit Points. When you reach 0 hit points, you continue fighting as normal, but you must make a death saving throw. Any damage you suffer while at 0 hit points automatically triggers a death saving throw.

Death Saving Throws. Roll a d20. If the roll is 10 or higher, you succeed. Otherwise, you fail. When you fail a death saving throw, you drop to 0 hit points and die.

This keeps characters on their feet and fighting longer (players get to keep playing the game), but risks outright death on a failed death save. No more pop-up healing as healing someone for one hit point because a pointless thing to do rather than the single most optimal thing to do.

If you wanted to make things even more deadly, you could introduce massive damage (more than 1/2 max hp) triggering a death save...or critical hits triggering a death save (hence the wording of the death save).

The massive damage option does up the ante, but can I ask how aggressive you are with monsters in combat? I don't disagree that characters are resilient, but I acknowledge that by rolling in HARD.

I don't avoid catching dying characters within a spell's area of effect, which automatically takes a death save away from them. It's a wicked thing to do but it puts the fear of God in them. Heh


I wouldn't target a dying character with an attack directly, though. It's not as much fun for players if a monster walks up and melees them.

 

[ReshiIRE]

Have you ever read the Cyberpunk Red rulebook (the game I want to won when I EVENTUALLY get out of my creative funk)? The rule you propose there seems very mechanically similar to how Cyberpunk RED works, which is a game that is more deadly in it's combat than 5e (especially since you can't heal abritrarily).

This does have the side effect of making healing very important, and I'm not sure how to feel abotu that in 5e as healing during combat seems weak (delibertly, from what I know) especially on spellcasters.

A house rule my group uses is that we use 'negative hp'. So you can drop below zero, and either a medicine check will get you up or healing all that damage so you are above 0 HP. Does make certain situations quite dangerous.

 

[Li Shenron]

If someone is at 1 hp there's a 100% chance that if they get hit they will take at least 1 damage...which will force a death save and give them the same 45% chance to die.

Ah now I noticed that you meant that when you drop to 0 you immediately have to make a death saving throw, I should have read more carefully. Ok then healing exactly 1 hp doesn't matter, so the case is somewhat improved but now healing exactly 2 does... so if you have someone who can choose exactly how many hp to heal (Lay on Hands, Goodberry) they can still optimize but it's not the cheapest.

 

[Dragonsbane]

That's a feature, not a bug. If nothing else it adds a bit of realism: being beaten nearly to death should be a lingering, painful experience, and it should definitely make you want to spend a day or two in bed recovering (at the very least).

Indeed, I have posted my house rule on this before, it is a feature Combined with my reduced healing, it is more grognard for me and my ancient players.

Combat​

Death & Dying​

When someone drops to zero hit points, they gain a level of exhaustion, even if they get right back up from healing or assistance right away

Death save failures stay with a character until a long rest.

Attackers have advantage against someone dying, and automatically cause a critical hit if within 5 feet.

A successful attack against someone dying gives a death save failure. A successful critical hit against someone dying gives 2 death save failures as well as a level of exhaustion.

Resting​

Long Rest​

At the end of a Long Rest, a character regains one hit point per character level plus its constitution modifier. The character additionally loses one level of exhaustion if they have any. The character also regains one Hit Die, and a character can spend any hit dice it has as if it had a short rest.

 

[OptionalRule]

It's a perennial problem with 5E. There's no lasting consequences of nearly dying. There's a lot of interesting house rules to solve the problem. This might just be one more to add to the pile, but I think it works well and solves a few problems without drastically changing much. There are changes to RAW, yes, but they're minor, I think. And the changes happen to solve a lot of related issues, I think.

So here goes...

Hit Points. When you reach 0 hit points, you continue fighting as normal, but you must make a death saving throw. Any damage you suffer while at 0 hit points automatically triggers a death saving throw.

Death Saving Throws. Roll a d20. If the roll is 10 or higher, you succeed. Otherwise, you fail. When you fail a death saving throw, you drop to 0 hit points and die.

This keeps characters on their feet and fighting longer (players get to keep playing the game), but risks outright death on a failed death save. No more pop-up healing as healing someone for one hit point because a pointless thing to do rather than the single most optimal thing to do.

If you wanted to make things even more deadly, you could introduce massive damage (more than 1/2 max hp) triggering a death save...or critical hits triggering a death save (hence the wording of the death save).

2 rules really transformed the game for me.

1. Failed death saves are not reset when you wake up. They only clear after a long rest.
2. You can't long rest on the road (I have rules for building a basecamp in the field)

 

[DEFCON 1]

Are we showing off our personal Rests and Death Save house rules? Okay, why not! I've made my own amendments to the Rest rules, Dying and Death save rules, and the Exhaustion chart so they all work together. This system has been used in a modified form previously in my Curse of Strahd campaigns (which were actually a bit more deadly than this to emphasize that setting), and will be run in this form in my upcoming Theros campaign.

Rests

• A Short Rest is 10 minutes, during which you may spend hit dice to regain hit points and regain features that refresh on a Short Rest.
  
  
• A Long Rest is 8 hours of light activity or sleep, after which you regain all of your spent hit dice, regain all features that refresh on a Long Rest, and you lose your level of Exhaustion if currently at Level 1 (creatures at any higher exhaustion levels do not lose any.) You do not automatically regain all hit points following a Long Rest.
  
  The effects of a Short Rest are included at both the beginning and end of a Long Rest. (I.E. you may spend any remaining hit dice you have at the beginning of the Long Rest to regain hit points, and then may spend any new hit dice you just regained following the Long Rest to regain more hit points.)
  
  
• An Extended Rest is 24 hours of uninterrupted bed rest in a safe location and counts as a Short and Long Rest. You regain all hit points, all hit dice, all class features, and may possibly reduce levels of Exhaustion you currently have. At the end of the Extended Rest another character may attempt a WIS (Medicine) check. A successful DC 10 check reduces your Exhaustion level by 1, a DC 20 check by 2 levels, and a DC 30 check by 3 levels.

Healing and Dying

• At 0 hit points, a creature is Incapacitated (not Unconscious) and begins making Death saving throws at the start of their turn with a DC 10 to succeed. (An Incapacitated creature can’t take actions or reactions but may still move.)
• Every level of Exhaustion a creature has raises the DC by 1.
• Each failed Death saving throw causes one level of Exhaustion.
• Death occurs at Exhaustion Level 6 (and not 3 failed Death saving throws.)
• All abilities and spells that regain or heal hit points do not affect Exhaustion levels.
• A creature may regain hit points while Incapacitated, but that does not remove the Incapacitated condition nor stop the rolling of Death saving throws.
• To remove the Incapacitated condition and stop the rolling of Death saving throws requires the target to be Stabilized.
• A character that makes three successful Death saving throws or rolls a Natural 20 on a Death saving throw automatically Stabilizes.
• Another character adjacent to an Incapacitated character can attempt to Stabilize them by using an Action to make a WIS (Medicine) check with a DC equal to the target’s current Death save DC.
• Stabilizing a creature does not remove any levels of Exhaustion.

Exhaustion Chart

• Level 1: Speed halved.
• Level 2: Max HP halved.
• Level 3: Disadvantage on attack rolls and saving throws.
• Level 4: Disadvantage on ability checks.
• Level 5: Unconscious.
• Level 6: Death.

There are additional bits of rules I did not include here because they are the same as the actual rules in the game (mainly regarding taking hits while at 0 HP and thus automatically failing death saves) and thus didn't want to bog the rules written down here with stuff I already know how to run. I think these rules will help out many sections of the whole process. Switching from Unconscious to Incapacitated for characters at 0 HP will allow them a chance to retreat when they are at 0 (or keep fighting if they really want to risk it), plus we avoid the narrative incongruity of getting "knocked unconscious", then woken up, then knocked out again, then woken up again and so forth in the same fight. It also makes stabilizing characters an important process (and giving the Medicine skill something to do) because simply regaining HP via healing spells does not automatically stop the process of dying. In theory you could heal someone's HP to full, but if you never stabilize them they could still drop dead from Exhaustion. This method really emphasizes HP as more the energy/stamina type, rather than wounds. The "physical injuries" come from the gaining of Exhaustion levels (and thus require bed rest to heal from, rather than just combat magic.)

The change that I'm most curious about to see how it works is the bit of regaining all hit dice following a long rest, instead of regain all hit points. It's going to kind of result in the same sort of thing because these rules allow you to immediately spend hit dice you have just regained following the rest to bump your hit points back up as high as you want... but there's always a fair chance you won't start the day at Max HP (either because you didn't roll well enough on your HD expenditures, or you just want to save some HD for later in the day.)

Some of these bits have not yet been tested and I'm sure I might have to amend some things later on as we play... but more of these rules have been used at my tables in some form or fashion or were adapted from other EN World posters' house rules that they said had worked for them, so I think I'm probably in pretty good shape with these.