D&D 5E (2014) House Rule Idea: conscious but Exhausted at 0 HP

[Charlaquin]

I've been using, since around 2018, a somewhat similar Vitality homebrew (the actual damage your body can take, represented by your 1st level hit points, when you reach 0 HP, with HP reflecting the abstract of avoiding real damage) instead of death saves. Death saves led to absurd scenarios and we hated whack-a-mole.

I am also not a fan of the whack-a-mole effect, but I don’t like having a separate pool of “meat points.” I would rather handle hits taken after 0 hp with some sort of abstract wounds system. Which was what lead me to replacing death save failures with exhaustion levels initially.

My plan for my next campaign (which I’m currently shooting for a March start), I plan to use the following house rule:

As mentioned above, when at 0 HP, you have to concentrate (as if concentrating on a spell) to remain conscious. Taking damage while at 0 HP results in death save failures and forces a concentration save as normal. If you lose concentration, you fall unconscious and become unstable. Regaining HP while unconscious stabilizes you but does not restore you to consciousness - you only regain consciousness after 1d4 hours.

My thinking is that this version of the rule will preserve the utility of Healing Word and other such in-combat healing spells being able to keep an ally who has been knocked down to 0 HP in the fight for another round, without the attendant whack-a-mole effect of characters at 0 bouncing in and out of consciousness every round.

 

[UngeheuerLich]

I also like that it automatically breas concentration spells.

I am also not a fan of the whack-a-mole effect, but I don’t like having a separate pool of “meat points.” I would rather handle hits taken after 0 hp with some sort of abstract wounds system. Which was what lead me to replacing death save failures with exhaustion levels initially.

My plan for my next campaign (which I’m currently shooting for a March start), I plan to use the following house rule:

As mentioned above, when at 0 HP, you have to concentrate (as if concentrating on a spell) to remain conscious. Taking damage while at 0 HP results in death save failures and forces a concentration save as normal. If you lose concentration, you fall unconscious and become unstable. Regaining HP while unconscious stabilizes you but does not restore you to consciousness - you only regain consciousness after 1d4 hours.

My thinking is that this version of the rule will preserve the utility of Healing Word and other such in-combat healing spells being able to keep an ally who has been knocked down to 0 HP in the fight for another round, without the attendant whack-a-mole effect of characters at 0 bouncing in and out of consciousness every round.

I like your Idea, because it auto breaks concentration spells and is tied to constitution saves.

Edit: probably I will use that rule. Maybe I will make another limitation: you are slowed as with the spell.

 

[Lanefan]

I came up with this House Rule idea the other day. What do you think of it?

Purpose: This house rule is meant to replace the Unconscious condition that occurs for characters at 0 hp. This house rule is meant to keep the players of "dying" characters involved in combat, while also introducing long-term consequences of falling to 0 hit points. Note that this rule would only apply to characters, not necessarily monsters or NPCs.

New condition: Staggered.

When a character reached 0 hit points, they are considered Staggered. A Staggered character suffers the following:

• The character immediately takes on one level of Exhaustion.
• At the start of each of the character's turns, the character takes another level of Exhaustion.
• When the character takes damage, they suffer a level of Exhaustion. Critical hits result in two levels of Exhaustion.
• Attack rolls against the character gain advantage.
• The character has disadvantage on Strength, Dexterity, and Constitution Saving Throws.

The Staggered condition ends whenever the character gains hit points. However, any levels of Exhaustion remain. The character may reduce their level of Exhaustion through Long Rests or other means, as normal.


In my mind (having not playtested this at all), this house rule would result in some of the following changes:

• Characters at 0 hp would still be the targets of attacks.
• Characters at 0 hp would have more strategic choices to make, rather than just a death saving throw.
• Characters would still "bounce back" from 0 hit points, but gain the ongoing consequence of Exhaustion.

What do you think?

Ubderneath all this they're still making death saves, right? Otherwise, how does a character in fact die in this system?

 

[Krachek]

Prophecy
As soon as the party well have some members with cumulative exhaustion levels
they will go directly to the Inn.

 

[Charlaquin]

Ubderneath all this they're still making death saves, right? Otherwise, how does a character in fact die in this system?

The effect of the 6th level of exhaustion is death.

 

[DND_Reborn]

New condition: Staggered.

When a character reached 0 hit points, they are considered Staggered. A Staggered character suffers the following:

• The character immediately takes on one level of Exhaustion.
• At the start of each of the character's turns, the character takes another level of Exhaustion.
• When the character takes damage, they suffer a level of Exhaustion. Critical hits result in two levels of Exhaustion.
• Attack rolls against the character gain advantage.
• The character has disadvantage on Strength, Dexterity, and Constitution Saving Throws.

FWIW, we used close to this system, gaining a level of exhaustion when you went to 0 HP, for over a year and it worked well.

Due to the penalties already built into levels of exhaustion, IMO you don't really need more penalties--they'll come in time.

We also added the Concentration check mechanic at 0 HP and with any hits after, to remain conscious.

You only removed the exhaustion penalties (instead of having a staggered condition) with rest or magic, as usual. Regaining HP didn't help remove the effects of exhaustion.

Finally, you gain "free" levels of exhaustion equal to your CON modifier. After these are used up, you suffer the effects as usual. For example, with CON 16 you could suffer three levels of exhaustion, and then the 4th would impose disadvantage on ability checks, the 5th would be half speed, etc.

IMO it is a simple mechanic to exploit, using Exhaustion to represent physical trauma. Like I said, we used this for over a year so if you want to know more about how it played out, let me know.

 

[BookTenTiger]

FWIW, we used close to this system, gaining a level of exhaustion when you went to 0 HP, for over a year and it worked well.

Due to the penalties already built into levels of exhaustion, IMO you don't really need more penalties--they'll come in time.

We also added the Concentration check mechanic at 0 HP and with any hits after, to remain conscious.

You only removed the exhaustion penalties (instead of having a staggered condition) with rest or magic, as usual. Regaining HP didn't help remove the effects of exhaustion.

Finally, you gain "free" levels of exhaustion equal to your CON modifier. After these are used up, you suffer the effects as usual. For example, with CON 16 you could suffer three levels of exhaustion, and then the 4th would impose disadvantage on ability checks, the 5th would be half speed, etc.

IMO it is a simple mechanic to exploit, using Exhaustion to represent physical trauma. Like I said, we used this for over a year so if you want to know more about how it played out, let me know.

What effect did you see in the campaign?

 

[DND_Reborn]

What effect did you see in the campaign?

First, in case I didn't mention it, we got rid of death saves in favor of this mechanic.

The whack-a-mole pretty much went away unless it was, literally, a matter of avoiding a TPK. When a couple PCs exceeded their "Endurance" (the "free levels of exhaustion"), getting to safety and resting became a priority. Pressing on with the effects (disadvantages and half speed, even half max HP!) made the game more challenging when the PCs were forced to trudge on.

When Endurance was exceeded and the 2nd level of exhaustion effect kicked in, players really started to question whether or not placing their PCs in danger was a good idea. By the 4th level of exhaustion, the players wanted to avoid fighting as much as possible IME.

Finding safety to take multiple long rests to remove the effects of exhaustion became important. Spending 5th level slots for Greater Restoration was painful, but sometimes necessary to bring a PC further from death.

One memorable moment was when we had a paladin PC who died because he stood his ground so the rest of the party could escape a shadow dragon. His speed was halved and he knew he couldn't escape, but he didn't want everyone else dying to try to save him, so he yelled for them to flee while he fought it and was killed.

Overall, it is a great mechanic and use of exhaustion (which is under-used IMO).

Other aspects I didn't mention before while at 0 HP:

1. You can only take an action, bonus action, OR move (not all of them) and cannot take reactions.
2. If you are concentrating on a spell, you must make a concentration check at the start of each of your turns.

I used to have a full write-up. I can look to see if I can find it if you want. Hope this all helps!

 

[DEFCON 1]

Please do! I've used Exhaution in place of death saves in the past as well, and have thought about adding onto the system in ways like it sounds you did. So I'd love to see your full write-up on your additions! Thanks!

 

[reelo]

I like the way "Crypts and Things" handles hp and dying:

HP are "exhaustion". During combat, there's no way to gain it back except a "strong drink" which grant 1d4hp. Once you're down to 0, attacks dig into your Con score. Those wounds can be healed with magic.