Level Up (A5E) Injury and Death

[p_johnston]

So the DMG has a really interesting rule on page 272, Injuries. In short whenever a PC gets knocked to 0 hp, takes a critical hit, or fails a death save by 5 or more they get an injury. The problem is that the chart they give in the book basically reads 1,2,3 become crippled 4-20 ignore the injury because it is healed by any magical healing (which is the most likely way you got up from 0hp anyways).

In my game I took this mechanic and adjusted it so that players can receive long term injuries that actually effect gameplay but that won't just immediately cripple them (usually).
1) a character can have a total number of injuries+death saving throw fails = to 1/2 their constitution. So a character with a 12 constitution can have up to 6 injuries + death saving throw fails.
2) death saving throws reset on a long rest and are rolled by the DM behind the screen.
3) whenever a character hits 0 hp, takes an amount of damage greater than their max HP, or is hit while at 0 hp they receive roll on my injury chart and receive an injury.
4) at every long rest a character may opt to receive one less HD back and heal one injury. Otherwise it takes magic of at least Greater Restoration level to heal an injury.

This mechanic seems to make going down actually matter to the players. Normally if a player is knocked to 0 during a dungeon it doesn't matter. They take a short rest, get a couple of cure wounds, chug a potion and it's like nothing ever happened. Hell even during combat half the time the bard uses healing word and the fighter just pops right back up with no effect. Injuries make the players make harder choices. "Do I revive the fighter so he can help us and risk him going down again, possibly dieing?" "I was just brought up. Do I rush back into combat or retreat and try to heal up for a couple of turns first?" "were half way through the dungeon and most of us have some injuries but we still have a fair amount of spells and HD. Do we push on and risk more injuries or stop?"

I have found that it makes combat a lot more intense, interesting, and potentially deadly in my games at least.

 

[CapnZapp]

Just beware the spiral of death phenomenon.

The reason losing your hit points in D&D has few if any consequences is because of this.

An individual group might not have any issues, so I'm not saying it's a bad rule for those who accept the drawbacks.

Only that it isn't for general usage.

 

[Morrus]

Ah, death spirals. I remember them well!

 

[glass]

The death spiral effect could be avoided (or at least greatly reduced) if one only rolls for injuries after combat. And I hate to use the "R-word", but it is probably more realistic that way as well.

_
glass.

 

[UngainlyTitan]

And what about combat that occurs after one has been injured?

 

[Minigiant]

I find that death sprials can be aviods if they either are a choice (fail a death saving throw or take an injury to suceed) or the more severe injuries only happen after a threshold of minor injuries are made (it's not a death spiral if you should be dead already).

 

[glass]

And what about combat that occurs after one has been injured?

Well, that would be bad, obviously.

_
glass.

 

[UngainlyTitan]

This might suggest that the use of sidekicks and hirelings my be useful so that the player can fall-back or promote one of these when their main character has their knees broken.

 

[p_johnston]

Oddly enough I've never seen this system devolve into a death spiral. In my experience most of the injuries are minor enough that they make combat slightly more difficult while still enabling characters to work. Only if you lose a major body part (about a 1/200 chance) is it actually debilitating. Most characters can function with a -1 to ac and a -1 to hit without becoming useless. I've had characters with 4-5 injuries still participating and effecting combat, just more cautiously.

I've been using it for around 3 years now of weekly sessions and I can say that I've had people actually lose a body part that long term mechanically hurt them less then 5 times. I've had an instant death once.

for the most part the effects I've seen are that it adds an additional decision point to when to take a rest and that people actually treat their HP as important instead of playing the Yo-Yo game of get hit, healing word, get hit, healing word, etc.

 

[glass]

Oddly enough I've never seen this system devolve into a death spiral. In my experience most of the injuries are minor enough that they make combat slightly more difficult while still enabling characters to work.

That is literally the definition of a death spiral. You take damage, and then combat is "more difficult".

_
glass.