Injury, Death and Dying

Health

Hit Points

Hit points are the measure of your ability to continue fighting. They are not specifically a measure of how injured you are, in the sense that losing 10% of your hit points does not mean the loss of 10% of your body. Instead, it represents a 10% reduction in your physical resources which permit you to fight, such as how much blood you've lost, how winded you are, etc. At the end of the day, it is a very abstract value, and cannot be converted into a formula to decide how many of the 206 bones in your body (assuming your character is human) are broken at any given time.

Of course, once your hit points go below 0, your character is no longer able to fight.

Temporary Hit Points

Certain effects give a character temporary hit points. These hit points are in addition to the character's current hit point total and any damage taken by the character is subtracted from these hit points first. Any damage in excess of a character's temporary hit points is applied to his current hit points as normal. If the effect that grants the temporary hit points ends or is dispelled, any remaining temporary hit points go away. The damage they sustained is not transferred to the character's current hit points.

When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.

While temporary hit points may have a duration lasting minutes or even hours, this is only in preparation of combat. Once an initiative roll is made (and combat begins), all temporary hit points currently applied or applied during the fight have their duration reduced to the end of combat (when the initiative order is dismissed) or until they are removed through damage, whichever is sooner.

Types of Damage

Damage

Damage is the classic measure of injury, distress or debilitation that has been inflicted upon a creature as a result of some dangerous event or activity, such as getting hit by that heavy thing the troll is swinging around. Damage is an abstract measure, much like hit points, which doesn't correlate to any specific amount of injury, blood loss or structural/skeletal damage to your character's form. However, damage is used to describe the declining ability of your character to continue fighting.

The amount of damage dealt by any particular creature, weapon or object can vary significantly, and depends on a number of factors, such as the wielder's (or creature's) strength, level (or CR), and the type of weapon or object being used. Other sources of damage may include traps, falling from a height, spells, and even environmental effects such as extreme cold or heat.

When something damages your character, it follows the following steps:

1. The damage is reduced by any factor you may have which reduces incoming damage by a percentage (such as insubstantial, which reduces damage by 50%)
2. It is then reduced by any DR or ER which is applicable to the type of damage you have received
3. The remainder is applied first to any temporary hit points your character may have
4. Finally, the remaining damage is applied to your hit points.

Sometimes you multiply damage by some factor, such as on a critical hit. Roll the damage (with all modifiers) multiple times and total the results. Note that when you multiply damage more than once, each multiplier is added to the others, not multiplied. For example, if you critically hit with an axe, which does triple damage on a hit, and that damage is doubled for some secondary reason (such as a spell effect), the total multiple is x5, not x6. It's still going to hurt a LOT.

Damage can be healed with spells, but also heals naturally with rest.

Non-Lethal Damage

Non-lethal damage (which is sometimes also called subdual damage or temporary damage), works differently from normal damage. Non-lethal damage is damage which is not intended to kill you, or is from a source which cannot kill you, but which can still impair your ability to continue fighting. Examples can include punching someone with your fist without the Improved Unarmed Strike, slashing someone with a (regular) whip, or striking someone with a sap. Exhaustion and even exposure to heat or cold temperatures can also deal non-lethal damage.

When you take non-lethal damage, keep a running total of how much you've accumulated. Do not deduct the non-lethal damage number from your current hit points. It is not "real" damage. Temporary hit points are not affected by non-lethal damage in any way, and are ignored when determining whether your non-lethal damage equals or exceeds your current hit points.

When your non-lethal damage equals your current remaining hit points (not counting any temporary hit points), you become Staggered. You cease being staggered when your current hit points once again exceed your nonlethal damage, or when you fall unconscious.

When your non-lethal damage exceeds your current hit points, you fall Unconscious.

Spellcasters who fall unconscious retain any spell-based effects (such as Shield (Spell) or Mage Armor (Spell)) they had before going unconscious.

If a creature's non-lethal damage is equal to his total maximum hit points (not his current hit points), all further non-lethal damage is treated as lethal damage. This does not apply to creatures with regeneration. Such creatures simply accrue additional non-lethal damage, increasing the amount of time they remain unconscious.

Healing Non-Lethal Damage

Unlike normal damage, non-lethal damage is healed quickly with rest. You heal non-lethal damage at the rate of 1 point per hour or rest per character level.

When a spell or ability cures hit point damage, it also removes an equal amount of non-lethal damage.

Example: A sturdy orc warrior has 100 hit points. His orc war chief grants him 50 temporary hit points. A monk, hoping to capture him alive, begins punching him, doing non-lethal damage, because monks can do that.

The first punch of the monk does 45 points of non-lethal damage. (Ow.) The orc warrior's temp hit points and normal hit points DO NOT CHANGE. The war chief is frustrated, because this is bypassing his best mojo.

The second punch does 56 points of damage. The orc warrior now has 101 points of non-lethal damage and drops in his tracks, despite having all 100 normal hit points and all 50 temporary hit points remaining and intact.

The orc warrior is laying there unconscious. The war chief uses Encouraging Word and heals him for 50 hit points. This healing, like all healing, also heals an identical amount of non-lethal damage and leaves the orc warrior with 51 points of non-lethal damage. The orc warrior wakes up, ready to go.

The Monk is tired and stops hitting the orc warrior. The Rogue steps in to "help". The Rogue doesn't want to do non-lethal damage, and stabs the hapless orc warrior for a whopping 80 points of actual hit point damage. This removes all 50 of the temporary hit points and does 30 hit points of real damage, leaving the orc warrior with 70 normal hit points and 51 points of non-lethal damage. The orc warrior is able to continue.

The Monk, aghast at the deadly strike of the rogue, hits the orc warrior again, doing more non-lethal, before the rogue kills the orc. The monk does only 20 points of non-lethal. This leaves the orc warrior with 71 points of non-lethal damage, but because he only has 70 current hit points due to the damage the rogue inflicted, down he goes again. It's a hard day to be an orc.

Exasperated, the war chief uses Encouraging Word again, and cures the orc warrior for another 50 hit points. This heals 50 points of non-lethal damage, leaving the orc warrior with 21 points of non-lethal, and also heals the orc warrior's normal hit points by 50. However, he only has 30 points of actual hit point damage (the other 50 came out of his temporary hit points), so he heals those 30, back to his maximum of 100. The orc warrior wakes up and decides to start using a shield. All this getting knocked out and waking up again is starting to make him woozy.

Inflicting Non-Lethal Damage with a Weapon that Deals Lethal Damage

You can use a melee weapon that deals lethal damage to deal non-lethal damage instead, but you take a -4 penalty on your attack roll.

Inflicting Lethal Damage with a Weapon that Deals Non-Lethal Damage

You can use a weapon that deals nonlethal damage, including an unarmed strike, to deal lethal damage instead, but you take a -4 penalty on your attack roll.

Injury and Death

You can always tell, at a glance, the general health of any creature, among the following statuses: unharmed, injured, bloodied, staggered, unconscious, or dead. This does not require a skill check, and anyone can do it. It is only when you want to know the precise amount of hit points a creature has lost that a Heal or Divinity check is necessary.

Unharmed

Your current hit points are equal to your maximum hit points. The presence or absence of temporary hit points are not factored into this.

Injured

You are no longer at maximum hit points, but still have greater than half of your maximum hit points.

Bloodied

You have been reduced to half your maximum hit points (rounded down) or fewer. Some special abilities have greater effects against bloodied creatures. It is generally good form to announce when you become bloodied, and for the GM to announce when a monster has become bloodied.

Staggered

You are at exactly zero hit points. You may take a single move action or standard action each round (but not both, nor can you take full attack or full-round actions). You can still take free actions, but not swift or immediate actions. You can take move actions without further injuring yourself, but if you perform any standard action (or any other strenuous action), you take 1 point of damage after completing the act. Unless your activity increased your hit points, you are now at -1 hit points and dying.

Staggered does not apply to monsters, since they are slain when they reach 0 or fewer hit points. If a monster needs to remain alive for plot reasons, being reduced to exactly 0 hit points knocks the creature Unconscious.

In general, very few creatures are capable of inflicting the staggered condition as a special attack (though all of them can do it through damage, given the opportunity).

Unconscious

You are no longer capable of taking actions, and pass out. You fall Prone and become Helpless. Unconsciousness results from having your current hit points drop below zero, but not drop so low that you are dead (a character is dead when their current hit points are less than or equal to their Character Level + CON score (not modifier)). Unconscious includes all the penalties of Helpless and Prone, including susceptibility to coup-de-grace attacks. Unconscious characters cannot take any actions except some free actions (such as saving throws), though some free actions are simply not possible (such as speaking). The GM is the final arbiter of which free actions are permitted.

Any conditions you were suffering under, and any bonuses or buffs you have applied to you (as from spells) typically remain in effect while you are unconscious (though they may not provide any benefit until you regain consciousness, as with fast healing). Any time limit on the conditions or buffs (i.e. 'until the end of your next turn', etc.) still tick down while you are unconscious.

Generally, monsters die upon reaching negative hit points, rather than becoming unconscious. If a monster needs to fall unconscious for story reasons, they generally just stop accumulating damage once they reach 0 hit points.

Dead

When your character's hit points reach a negative total of its CON stat value (not your CON modifier) plus character level, it dies. A character can also die from certain status conditions, spells, or special abilities. Regular healing spells, such as Cure Critical Wounds (Bard Spell), and potions, scrolls or other effects which make use of healing spells, have no effect on dead characters. Furthermore, a character's fast healing (if any) ceases after death.

Only certain types of powerful magic, such as Raise Dead (Cleric Spell) and Resurrection (Cleric Spell), which specifically state they restore life to slain creatures, may be used to bring a character back from death. Note that being brought back to life via these sorts of spells does not cause you to become undead. Becoming undead requires a different sort of spell entirely — typically one which animates the corpse through the introduction of a new soul, or torments the departing soul into becoming a malevolent spirit.

Any status conditions, bonuses, buffs, or debuffs that a creature had applied to them are immediately removed when a creature dies, unless the ability which applied the condition or bonus explicitly states that it can persist even after a creature dies (such as Cursed, or Ability Drain).

Monsters typically die upon reaching 0 or fewer hit points.

In addition, there are two statuses which can occur when a creature is unconscious: dying and stabilized. Unlike the statuses above, these are not detectable from simple observation, but only through examination with either a Heal or a Divinity check.

Dying

Any time your hit points are at a negative number, but you are not instantly slain (i.e. your hit points are below zero, but not less than a negative total equal to your CON score (not modifier) + your character level), you are Dying. You gain the Unconscious condition and can take no actions. While dying, you must make a death check at the end of each of your turns, as a free action, to determine whether you continue to bleed out, or stabilize. A death check is resolved as follows:

Death Check: d20 (no modifiers*) vs. a DC of 12

* – rare modifiers to this check exist, such as from the Diehard feat.

If you succeed on the roll, you remain unconscious, but you stabilize and are no longer dying. If you fail the check three times in a row (over the course of three rounds), you die.

If you reach a negative hit point total of your CON stat (not stat mod) plus your level, you die. Most NPC's die when their hit points go below zero, but some NPC's only die when they reach negative their CON stat (not modifier) plus Level. NPC's cannot stabilize without some special ability such as regeneration or assistance from an ally.

Stabilized

Can occur at any hit point value of 0 or less. A stabilized character is no longer dying. A stabilized character with negative hit points is still Unconscious and cannot take any actions. The stabilized condition can be achieved via a successful Death Check to stabilize, a Heal check from an adjacent ally, or via magical healing. See "Stabilizing the Dying" for more details.

Stabilizing the Dying

An adjacent ally can attempt to stabilize a dying character by making an Easy DC Heal check versus the level/CR of the dying character. If the check succeeds, the character's hit points are restored to 0, regardless of whatever negative total they previously sustained. The character replaces the 'dying' status with the 'staggered' status, but remains Prone. The character is at no further risk of dying until they take additional damage that reduces them below 0 hit points again. Note that Heal checks can be performed even if a character has stabilized via a CON check.

If magical healing (e.g. a spell, scroll, potion, etc.) is used on a dying character instead of a Heal check, damage is restored from whatever negative value the character is currently at, but the character replaces the 'dying' status with the 'stabilized' status. While less efficient than performing a Heal check first, magical healing is a risk-free way to stop a character from losing 1 hit point per round and potentially bleeding out.

Recovering Without Help

A severely wounded character left alone usually dies. He has a small chance of recovering on his own. Treat such characters as those attempting to recover with help, but every failed Constitution check to regain consciousness results in the loss of 1 hit point. An unaided character does not recover hit points naturally. Once conscious, the character can make a DC 10 Constitution check once per day, after resting for 8 hours, to begin recovering hit points naturally. Failing this check causes the character to begin 'dying' again, losing 1 hit point per round until either stabilizing or reaching a negative hit point total which causes them to die. Characters which succeed on this check begin recovering hit points normally, and are no longer in danger of losing hit points from their weakened condition.

Types of Healing

Instantaneous Healing

Various abilities and spells can restore hit points. Spells which result in an instant influx of hit points to the target creature are deemed Instantaneous Healing. This does not refer to how long the spell takes to cast, only to the fact that the healing effect of the spell expends all of its beneficial effects on the target creature immediately upon the completion of casting. Examples include Cure Light Wounds (Spell), Heal (Spell), Goodberries (Spell), etc.

Some abilities are only triggered by instantaneous healing, such as the Fighter's tactic "Healer's Friend". In such cases, persistent healing (see below) does not trigger these abilities.

Persistent Healing

Persistent healing is healing which occurs over a period of time. Healing from rest is considered persistent healing, but so is regeneration and fast healing. A warlord's Exhortation ability or a bard's Soothing Performance are also persistent healing abilities. Even a spell which has a large healing effect the first round it is cast but then provides additional healing in future rounds is considered persistent healing. For example, applying the metamagic Echoing Spell (Spell) to Heal (Spell) would change it from an instantaneous healing ability to a persistent healing ability.

Natural Healing

With a full night's rest (8 hours of sleep or more), you recover 1 hit point per character level. The 8 hours of sleep need not be consecutive, but need to occur within no greater than a 12 hour period, or your rest was too interrupted to receive any natural healing benefit from it.

If you undergo complete bed rest for an entire day and night (24 hours consecutively), you recover twice your character level in hit points.

While not specifically related to hit point recovery, a full night's rest also restores 1 point of ability damage to each ability score which sustained damage. A full day's rest (24 hours) restores 2 points of ability damage to each ability score which sustained damage. See Ability Damage for details.