Injury and the risk of death are constant companions of a fantasy adventurer.
Table of Contents
Hit Points
Every creature has a number of hit points (HP) representing a combination of its physical and mental durability. Creatures with more hit points are more difficult to kill. Those with fewer hit points are more fragile.
At full health, a creature is at its hit point maximum. At any given moment, a creature’s current hit points can be any number from its hit point maximum down to 0. This number changes frequently as a creature takes damage and receives healing.
Whenever your character takes damage, subtract that amount from its current hit points. The loss of hit points has no effect on a creature’s capabilities until the creature drops to 0 hit points.
Temporary Hit Points
Some spells and special abilities give you temporary hit points. These are a buffer against damage, an extra pool of hit points that protects your current hit points.
When you take damage while you have temporary hit points, subtract the damage amount from the temporary hit points first. Any leftover damage then carries over to your current hit points. For example, if you have 5 temporary hit points and take 7 damage, you lose the 5 temporary hit points and then take 2 damage to your current hit points.
Because temporary hit points are separate from your current hit points, they can exceed your hit point maximum. You can be at full hit points and receive temporary hit points.
Healing can’t restore temporary hit points, and you can’t stack temporary hit points together. If you have a pool of temporary hit points and then get more from another source, decide whether to keep the ones you have or take the new ones. For example, if a spell grants you 12 temporary hit points when you already have 10, you can have 12 or 10, not 22.
If you have 0 HP, receiving temporary hit points doesn’t restore you to consciousness or stabilize you. If they absorb all the damage from a hit, you don’t have to fail a death save.
Unless a feature that grants you temporary hit points has a listed duration, they last until depleted or you finish a long rest.
Damage
The most common type of harm dealt to creatures is represented by damage. Different attacks, spells, and other harmful effects deal different types of damage.
Damage Types
Damage types have no rules of their own, but other rules, such as damage resistance, rely on the types.
The damage types are provided here, with examples to help a GM assign a damage type to a new effect.
Acid. The corrosive spray of a black dragon’s breath and the dissolving enzymes secreted by a black pudding deal acid damage.
Bludgeoning. Blunt force attacks, such as hammers, falling, and constriction, deal bludgeoning damage.
Cold. The infernal chill radiating from an ice devil’s spear and the frigid blast of a white dragon’s breath deal cold damage.
Fire. Red dragons breathe fire, and many spells conjure flames to deal fire damage.
Force. Force is pure magical energy focused into a damaging form. Most effects that deal force damage are spells, including magic missile and spiritual weapon.
Lightning. A lightning bolt spell and a blue dragon’s breath deal lightning damage.
Necrotic. Necrotic damage, dealt by certain Undead and a spell such as grave touch, withers matter and even the soul.
Piercing. Puncturing and impaling attacks, including spears and monster bites, deal piercing damage.
Poison. Venomous stings and the toxic gas of a green dragon’s breath deal poison damage.
Radiant. Radiant damage, dealt by a cleric’s flame strike spell or an angel’s smiting weapon, sears the flesh like fire and overloads the spirit with power.
Slashing. Swords, axes, and claws deal slashing damage.
Thunder. A concussive burst of sound, such as the effect of the thunderwave spell, deals thunder damage.
Damage Resistance and Vulnerability
Some creatures and objects are exceedingly difficult or easy to hurt with certain damage types.
If a creature or an object has resistance to a damage type, damage of that type is halved against it. If a creature or an object has vulnerability to a damage type, damage of that type is doubled against it.
Resistance and then vulnerability are applied after all other modifiers to damage. For example, a creature has resistance to bludgeoning damage and is hit by an attack that deals 25 bludgeoning damage. The creature is also within a magical aura that reduces all damage by 5. The 25 damage is first reduced by 5 and then halved, so the creature takes 10 damage.
Multiple instances of resistance or vulnerability that affect the same damage type count as only one instance. For example, if a creature has resistance to fire damage as well as resistance to nonmagical damage, the damage of a nonmagical fire is reduced by half against the creature, not reduced by three-quarters.
Healing
Unless it results in death, damage isn’t permanent. Rest can restore a creature’s hit points, and magical methods such as a cure wounds spell or a potion of healing can remove damage in an instant.
When a creature receives healing of any kind, hit points regained are added to its current hit points. A creature’s hit points can’t exceed its hit point maximum, so any hit points regained in excess of this number are lost. For example, a druid heals a ranger for 8 HP. If the ranger has 14 current hit points and has a hit point maximum of 20, the ranger regains only 6 HP, not 8.
A creature that dies can’t regain hit points until magic such as the revivify spell has restored it to life.
Hit Dice
Every PC has a number of hit dice equal to their character level. Hit dice are a measure of a character’s personal fortitude and allow you to heal yourself without magical assistance during a short rest.
The size of your hit dice depends on your class levels. Wizards have a d6, while barbarians have a d12.
Resting
Heroic though they might be, adventurers need rest—time to sleep, eat, tend their wounds, refresh their minds and spirits for spellcasting, and prepare for further adventure.
Adventurers can take short rests during an adventuring day and a long rest to end the day.
Short Rest
A short rest is a period of downtime, at least 1 hour long, during which a character does nothing more strenuous than eating, drinking, reading, and tending to wounds.
You can spend one or more hit dice at the end of a short rest, up to your maximum number of hit dice (which is equal to your character’s level). For each hit die spent in this way, roll the die, and add your character’s CON modifier to it. The character regains hit points equal to the total. You can decide to spend an additional hit die after each roll until you run out of hit dice. You regain some spent hit dice upon finishing a long rest, as explained in the Long Rest section.
Long Rest
A long rest is a period of extended downtime, at least 8 hours long, during which a character sleeps or performs light activity: reading, talking, eating, or standing watch for no more than 2 hours. If the rest is interrupted by strenuous activity—at least 1 hour of walking, fighting, casting spells, or similar adventuring activity—the character must begin the rest again to gain any benefit from it.
At the end of a long rest, you regain all lost hit points up to your hit point maximum. You also regain spent hit dice, up to half of your maximum (minimum of 1). For example, if your character has 8 hit dice, you regain 4 of them upon finishing a long rest.
A character can’t benefit from more than one long rest in a 24-hour period, and a character must have at least 1 hit point at the start of the rest to gain its benefits.
Dropping to 0 Hit Points
When you drop to 0 HP, you either die outright or fall unconscious and are dying. These rules are primarily used during initiative in an encounter. In rare instances, character death can occur outside of an encounter, especially through dangers covered in the Other Forms of Harm section. The GM decides how these rules function in deadly situations that occur outside of initiative.
Death
Massive damage can kill you instantly. When damage reduces you to 0 HP and more damage remains to be taken, keep track of it. Your character is dead when you are at 0 HP and have either failed three death saves or taken as much damage as your hit point maximum while at 0 HP. Magical healing or a WIS (Medicine) check can’t help you at this point. Only a spell like revivify or resurrection can bring the character back to life.
For example, a cleric with a hit point maximum of 12 currently has 6 HP. If she takes 18 damage from an attack, she is reduced to 0 HP, and 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.
Death Saves
When you start your turn with 0 HP, you must make a special save, called a death save, to determine whether you creep closer to death or cling to life. Unlike other saves, a death save isn’t tied to any ability score.
Roll a d20. If the roll is 10 or higher, you succeed on the death save. Otherwise, you fail. An individual success or failure has no immediate effect. However, on your third success, you become stable. On your third failure, you die.
Successes and failures don’t need to be consecutive; keep track of both until you collect three of a kind. The number of both resets to zero when you regain any hit points or become stable.
Rolling 1 or 20. When you make a death save and roll a 1 on the d20, it counts as two failures. If you roll a 20 on the d20, you regain 1 hit point and are conscious again, no longer needing to make death saves.
Damage at 0 HP. If you take any damage while you have 0 HP, you suffer an automatic death save failure. If the damage is from a critical hit, you suffer two failures instead. If the damage equals or exceeds your hit point maximum, you die instantly.
Dying
If damage reduces you to 0 HP and doesn’t kill you, you are dying. Dying is when you are at 0 HP and must make a death save at the start of your next turn. You have the unconscious condition. If you gain hit points while dying, you stop dying. Your unconscious condition ends, but you are still prone.
Stable
The best way to help a creature with 0 HP is to heal it. Barring that, the creature can at least be stabilized. You are stable when you are at 0 HP and don’t need to make a death save. You still have the unconscious condition. Becoming stable wipes the slate clean of successes and failures on death saves.
You can use your action to try to stabilize a dying creature with a successful DC 10 WIS (Medicine) check. A stable creature remains at 0 HP and is still unconscious, but it doesn’t make death saves and is not in imminent danger of death. If the creature takes any damage while stable, it returns to dying and must start making death saves again if it takes any damage.
A stable creature that isn’t healed but takes no more damage regains 1 hit point and ends the unconscious condition after 1d4 hours.
Monsters and Death
Monsters generally die the instant they drop to 0 HP, since tracking death saves for a dozen monsters can be tedious.
Mighty villains and special NPCs are common exceptions, though. The GM can decide to have them fall unconscious and follow the same rules as PCs if it better suits the story.
Other Forms of Harm
While damage is the most common form of harm, other effects can bring short-term or long-term harm to PCs.
Conditions
Many monster attacks, spells, and other dangers impose conditions on PCs. A condition, such as blinded, charmed, or frightened, can hinder a creature without damaging it. Depending on its source, a condition can last for a few seconds or until a magical cure is found.
Pay special attention to exhaustion—that condition can outright kill a PC and is often inflicted by environmental hazards and other forms of harm.
Curses
Curses are supernatural afflictions that magically hamper or alter their victims. Objects, creatures, and even areas can be the target of a curse. Most curses can be ended through use of a remove curse spell, greater restoration spell, or similar magic. Some curses, like those that come with cursed magic items, are only temporarily suppressed by spells like remove curse. The most powerful curses can be broken only by performing specific actions or triggering narrative effects specific to the curse.
Diseases
Diseases are physical afflictions that can be contracted from some monsters, hazards, or exposure to necromantic magic. A disease typically ravages its victim over multiple days, causing more damage the longer it is left untreated. While common diseases might be cured with a WIS (Medicine) check, spells like lesser restoration and similar magic are often required to cure more potent diseases.
Dread
When PCs witness terrors beyond mortal comprehension, they might be inflicted with dread. Dread goes beyond standard fear. It is severe psychological harm that can scar a creature for minutes or indefinitely until magical intervention is used.
Poisons
Poisons are tools used by PCs and monsters to cause harm or injury.
Starvation and Dehydration
Characters who don’t eat or drink suffer the effects of exhaustion. Exhaustion caused by lack of food or water can’t be removed until the character eats and drinks the full required amount.
Food
A typical character needs to eat one pound of food per day. You can make food last longer by eating half rations. Eating half rations in a day counts as half a day without food.
A character can go without food for a number of days equal to 3 + CON modifier (minimum 1). Beyond that, a character automatically suffers one level of exhaustion at the end of each day they haven’t eaten.
One normal day of eating resets the count of days without food to zero.
Water
A character needs one gallon of water per day or two gallons per day if the weather is hot. A character who drinks only half that much water must succeed on a DC 15 CON save or suffer one level of exhaustion at the end of the day. A character who drinks even less water automatically suffers one level of exhaustion at the end of the day.
If the character already has at least one level of exhaustion, the character suffers two levels each day with little or no water.
Suffocating
Most creatures, particularly most PCs, need to breathe air to survive. When a creature can’t breathe, such as while submersed in water, it must hold its breath.
A creature can hold its breath for a number of minutes equal to 1 + its CON modifier (minimum of 30 seconds).
When a creature runs out of breath or is choking, it can survive for a number of rounds equal to its CON modifier (minimum of 1 round). If it is still out of air at the start of its next turn, it drops to 0 HP and begins making death saves. The creature can’t regain hit points or be stabilized until it can breathe again.
For example, a creature with a CON modifier of +2 can hold its breath for 3 minutes. If it starts suffocating, it has 2 rounds to reach air before it drops to 0 HP.
