Lasting Injuries

When a player character is knocked down in combat, it usually means only being knocked unconscious for a few rounds, just to get up again like nothing happened. On rarer occasions, being knocked down even means death. They’ve taken quite the beating, and these expanded rules are meant to show that, while also promoting a more strategic approach to combat that doesn’t focus on getting knocked down, only to stand up like nothing happened. Here’s a list of lasting injuries for when PCs get hit really hard.

Minor versus Major

When knocked down, make a Constitution check. The starting DC is equal to 5, increasing by 1 increasing by 1 per max hit die of damage taken past 0 (6 for wizard, 8 for bard, 10 for fighter, 12 for barbarian, etc.). The DC increases by 1 for every time a character has been knocked down in a specific combat. If a player fails the test, roll on the minor injuries table. If the player fails the test by 5 or more, roll on the major injuries table.

Recovery The recovery time for minor and major injuries are different. For minor injuries, roll 1d10+5 for days to recover. For major injuries, roll 2d10+5 for days to recover. While recovering from a major injury, you have 1 exhaustion point that cannot be reduced until you spend the needed amount of time recovering. This time is halved with mundane medical attention each day, and quartered with medical attention of healing spells or professional surgeon (someone with a medicine skill of +7 or higher) each day. It is recommended that with this rule being used, you allow medicine to be either a Wisdom or Intelligence skill.

Lasting Injuries

Some major injuries are lasting. For example, it's possible for a player character to lose an eye, or the function of a limb. These unique injuries are not recovered from after the specified time, but from high level spells or high quality medical attention. Depending on your setting, care for these injuries can be easy to come by, or it could be a large quest in itself to find a skilled enough healer, whether it’s a physician or magical healer.

Location For the injuries that specify side, roll a d2. A result of 1=Left, and a result of 2=Right.

Spells Targeting Injuries

For recovery from injuries with healing magic, healing spells must target the injury itself. This means that the creature getting healed regains half of the hitpoints they normally would, but the healing from the spell also manages to ease the pain of their injury, speeding up recovery significantly.

Minor Injuries

When a player takes a minor injury, roll a d10. The meaning of each result is listed below. Recovery time for these injuries is 1d10+5 days, as stated above.

1-Broken Ribs: You can no longer take bonus actions until the injury has healed.

2-Broken Leg (d2): You immediately fall prone, and your movement is reduced by 10 until the injury is healed. You gain disadvantage on Dexterity Saving throws, Athletics, Acrobatics, and Stealth checks.

3-Broken Arm (d2): You immediately drop whatever you're holding in that arm, requiring you to pick it up as an object interaction. You can no longer use the arm that was broken without sustaining injury until the injury is healed. You can push yourself to use it, but you take 1d4 damage for every turn you do so.

4-Concussion: You gain disadvantage on Intelligence and Wisdom Saving Throws, as well as Concentration checks, until the injury is healed.

5-Sprained Ankle (d2): You immediately fall prone, and your movement is reduced by 5 until the injury is healed.

6-Sprained Wrist (d2): You immediately drop whatever you were holding in that hand, requiring you to pick it up with an object interaction. Your attack and damage rolls are reduced by 1 until the injury is healed.

7-Bruised Ribs: You take 3 levels of exhaustion. This injury requires no further recovery time.

8-Struck Head: You gain the stunned condition for 1d4 rounds, stumbling around in your current square and suffering from 2 levels of exhaustion. This injury requires no further recovery time.

9-Dislocated Shoulder: You may spend a full turn to put the dislocated shoulder back into place, or have an ally to spend an action to do so. Additionally, you take 2 levels of exhaustion. This injury requires no further recovery time.

10-Adrenaline Rush: Instead of being knocked unconscious, you’re left standing with 1 hit point. You can immediately take an extra turn. After the turn, you gain 2 points of exhaustion. This injury requires no further recovery time.

Major Injuries

When a player takes a major injury, roll a d10. The meaning of each result is listed below. Recovery time for the non-permanent of these injuries is 2d10+5 days, as stated above. Regardless of the injury, someone that sustains a major injury has a minimum of 1 level of exhaustion during the time of recovery, unless the injury states that they gain any other amount of exhaustion levels. The effects of lasting injuries cannot be recovered from.

1-Destroyed Heart: Instantly die.

2-Punctured Gall Bladder: Make a DC 20 Constitution saving throw. On a success, you gain 3 levels of exhaustion until you recover. If failed, you have 1d4 rounds to live unless a level 3 healing spell or higher targets the injury. If you survive, you have 3 levels of exhaustion until you recover.