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My 5e D&D Injury System

So a while back I made a post detailing my “Injury System” for Dungeons & Dragons 4th Edition.  It was roughly modeled after the Dragon Age: Origins injuries but without all the unruly book keeping that came with the ups and downs of temporarily changing ability scores.   Well, now a new edition of the game is upon us and I figured why the heck not update that old chart for the newest edition of the game.  It’s something to work with right?  While the new Dungeon Master’s Guide DOES have an Injury chart, it feels a bit severe and well – permanent – than some of my injuries. My injuries are things you see happening to inconvenience someone that they would sustain in a fight.  The official table in the book is like…  OH BAHAMUT YOU ARE #$%&ED UP!  I mean, losing body parts? Yeuch!  So here’s MY chart:

Roll 1d6
Roll Result Normal Effect Complicated Effect
1 Injured Arm Disadvantage on Strength Checks & Saves Disadvantage on Strength checks & saves. Disadvantage on Melee & Ranged attack rolls.
2 Injured Leg Disadvantage on Dexterity Checks & Saves. Speed reduced by 5 feet. Disadvantage on Dexterity check & saves. Speed reduced by 15 feet.
3 Cracked Skull Disadvantage on Wisdom and Intelligence Checks & Saves Disadvantage on Wisdom and Intelligence rolls. Including spell attack rolls. Can’t use spells that use concentration.
4 Cracked Rib Disadvantage on Constitution Checks & Saves.  Disadvantage on Constitution rolls. Vulnerable to Piercing, Slashing, and Bludgeoning damage.
5 Stomach Wound No CON modifier when you roll hit dice. No CON modifier when you roll hit dice. Hit dice roll is halved (round down.)
6 No Injury Sustained

As before, falling unconscious will result in one injury from the normal effect column (unless they roll a 6.) This injury can be treated in a town or city (DM Tip: feel free to charge a physician’s fee, or have a doctor ask a favor for treatment. Great story hook!) or by a DC 15 Wisdom (Medicine) check in the field and outside of combat.  However, if the players opt for the Wisdom (Medicine) check, a failure will result in the injury becoming complicated, and become the corresponded complicated effect.  A complicated injury MUST be treated in a town or city.

There’s also an alternate rule with these that I came up with after playing some test games of 5th edition and found that especially at low level things can be particularly deadly for players.   I’m sure that’s great for a lot of DMs and Players out there.  Lethal, deadly, and  risky – Yay.  Yea, that’s how a dungeon crawl SHOULD be.  But for me?  I prefer a good story.  So do my players.  So having characters drop like flies isn’t exactly a great feature for me and mine.  So I also added this:

Alternate Death Rules:  In the event that a character dies (by failing 3 death saves or taking lethal damage) they can try to be resuscitated after combat is over.  By making a Wisdom (Medicine) check with a DC 20, they can be brought back from the brink but automatically sustain 2 complicated injuries.  Roll against the injury chart above with 2d6 instead of 1.  The PC will sustain both injuries.  If one of the dice is a 6, reroll it until you get a 1-5.  If BOTH dice end up being rolled as 6s, then the PC has complications during the resuscitation and dies permanently.

Naturally you can play around with these making them worse or easier by switching around the DCs. Like a DC 10 to treat an injury and a DC 15 to resuscitate using those alternate dying rules. Or crank them up with you wanna get edgy with it.

What Doesn't Kill Ya: My D&D Injury System

Recently I had a new Dungeons & Dragons 4e campaign start, my first in over 6 months that I was DMing and the first time I had DMed a game since actually getting to sit on the player side of the screen.  Needless to say it made a big difference.  One thing I really wanted to do was patch up some of the holes that my last campaign had as well as some that observed in my gaming experiences.

A big one was going unconscious mid-battle should be a bigger deal than “Oh, I have to start making Death Saves”  So I got to searching for a good way to raise the stakes.  That’s when I stumbled upon this article on RoleplayingTips.com.  It describes a system in which a player sustains an injury when they get knocked out in battle, mostly taken from Dragon Age.   This was my starting point for coming up with my system and it doesn’t change too much from this except for a few minor things.

First of all, I’m not a big fan of unnecesary book keeping and taking a straight minus to an ability score creates just that.  Every skill associated with that ability score gets temporarily changed, the attacks and damage have to be altered, and if you want to be really mean it can alter your hit point total and number of healing surges as well.  Ultimately it just sounded like a big hassle and I wanted to really make it easy.  So I built a system around taking a loss that get tacked on to the end of roll instead of the beginning and having to rework a lot because of it.

My second change was I shortened up the list, but doubled up the results.  Essentially the list got halved and each injury gives minuses to two things.  Some are worse injuries to have than others to be sure, and to get some reprieve I inserted a chance that you would not receive an injury at all.  Also, a player can only suffer a maximum of three injuries at a time. I ended up with this chart:

Roll 1d6.
1 Injured Arm -1 to Attack and Damage Rolls
2 Injured Leg -1 to Speed and Initiative Rolls
3 Sore Skull -1 to Perception and Saving Throws
4 Bruised Rib Gain Vulnerable 2 to all damage
5 Stomach Wound Healing Surge Value is Reduced by 1/4
6 No Injury Sustained

Granted, that’s just for the Heroic tier.  I haven’t decided if it will scale in the other tiers of play but I have a good while to decide that.  The next task was to figure out how they can cure their injuries.  The easiest answer was that the next time they are in a non-hostile town (I call them Points of Civilization, which I explain to my players as “Somewhere that has a warm bed, a fluffy pillow, and they aren’t trying to kill you.”) however I wanted to get them a quicker solution.  So I came up with two ways to cure the injury: Rest at a point of civilization or make a Hard DC heal check.

The Hard DC heal check was in hopes that only someone trained in healing would be able to fix the injuries, but even those who aren’t can stand a chance.  The downside to the immediate gratification of healing it through a check is that there is a chance to flub it and make it worse.  A failed check will complicate the injury and make it worse, causing the effects to double (or in the case of a ‘Complicated Bruised Rib’ Vulnerable 5 instead of 2) and a complicated injury can ONLY be healed a point of a civilization.  Still not a complete show stopper, but it does give it a bit of gamble.

So that’s my current system that I’m using to handle injuries when they go unconscious.  It’s a quick and easy system that gives players a few options and still encourages them to not shrug off going unconscious.  Thanks for reading!

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