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Message: <blockquote data-quote="DEFCON 1" data-source="post: 6126784" data-attributes="member: 7006">I am currently in the midst of my campaign that uses long-term wounds from falling unconscious and failing death saves.  My rule also incorporates a loss of max HP when you are suffering wounds... which has made things "grittier" for our game since you can't automatically go back to Max HP all the time, regardless of how many times you've been knocked out.  Here are the rules I'm using:A PC calculates his HP total normally.  His Bloodied value is still 1/2 his HP total.  We also calculate two other values... his Bruised value at 3/4 his HP total, and his Injured value at 1/4 his HP total.  So a PC who has 48 HP (for example) has his values look like this:Healthy: 48Bruised: 36Bloodied: 24Injured: 12The PC's Healing Surge value is still the typical 1/4 of the HP total, which in this case is 12.Hit point damage suffered through attacks comes off the HP total like usual.  This HP loss for us is entirely fatigue, luck, morale, and superficial nicks and bumps.  No actually wounds are suffered.  These HP can also be healed like normal in 4E-- clerical magic healing, warlord inspirational healing, etc. etc.Should someone fall below 0 HP from an attack, they immediately suffer the "Unconscious" condition.  For us, "Unconscious" might not necessarily mean actually blacking out... but rather that you've suffered an actual wound that takes you out of the fight for a time.  A stab wound, a gash, a dislocated or broken limb, concussion, severe burns or whatever (usually whatever makes senses based upon the attack that caused it).At this point, your "Wound Level" drops from Healthy to Bruised (which gets ticked off on the sheet.)  From now on... until the PC spends 1 or more days in complete rest to recover from that wound... his max HP now drops to his Bruised number.  So during or after the fight... as our example PC spends healing surges to recover... he no longer can go back up to 48 HP, but rather the most he can go up to is 36 (because his Wound Level has dropped to Bruised.)  Only after he spends the time in rest and recovery can he eliminate the Wound Level, and thus allow him to begin spend surges to get back up to his full HP amount.In addition to this... after the PC suffers the "Unconscious" condition and his Wound Level drops from Healthy to Bruised... each Failed Death Save drops his Wound Level once more.  So the typical 4E "three strikes and you're dead" rule occurs alongside a drop from Bruised to Bloodied on the first failed save, Bloodied to Injured on the second failed save, and Injured to you're dead after the third failed save.  But just like what happened when the PC's Wound Level dropped to Bruised... if he failed death saves and dropped to Bloodied or Injured... THAT'S now the maximum amount of HP the character can get back up to following the fight, should he have survived.  Thus... our example PC falls Unconscious and his Wound Level drops to Bruised.  He then fails one death saving throw and his Wound Level drops to Bloodied.  At that point in the fight a fellow player heals him in some fashion and he is able to pull himself back to his feet (having spent a healing surge to regain 12 HP).  However, his maximum HP is now down to 24, his Bloodied value.  Once the fight is over and he takes a Short Rest, that's the most HP he can recover to, since he's currently suffering two Wounds.It thus far has proven to be very, very effective for a couple reasons.  First... it makes falling to 0 have actual consequences... and thus the group's tactics have changed quite a bit.  The so-called "ranged" characters now no longer just sit back pew-pewing without a care in the world while their fellow melee characters take attack after attack after attack... because they know that if they don't occasionally jump in and peel off some of the monsters... their melee friends will fall to 0, suffer wounds, and thus end up not having many HP after the fight with which to continue adventuring.  So it behooves them to absorb some attacks themselves to forestall their melee brethren from falling unconscious whenever possible.  Otherwise... their adventuring grinds to a halt while everyone waits for the melee attackers to recover from their wounds.  The wizard realizes that "taking one for the team" and actually getting hit occasionally only helps them all in the long run... because him suffering 15 HP in damage (which will be recovered during a Short Rest) has less long-term consequences than making the Fighter take it, him fall below 0, and now the party has to wait for recovery (or else continue on, but now their tank is not at full strength.)And the second gain from this method is that since many times the party just cannot stop for a couple days to a week to "recover" from wounds... they press on anyway.  And thus... the PCs have less total hit points available for subsequent fghts.   As a result, I don't have as many HP I need to grind through and can speed up combat by not throwing out as many monsters to make challenging encounters.It's been a win all around thus far.</blockquote>

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