These rules provide a framework for handling injuries more realistically in your campaign. Injuries result from critical hits, massive damage, traps, or specific called shots and are categorized by severity: minor, major, severe, and critical. Treatment ranges from quick actions to long-term care or magical healing.

Resting: During a long or short rest, players may spend Hit Dice to regain hit points, adding their Constitution modifier to each roll. Additionally, any non-severe injuries are automatically healed when Hit Dice are used in a long rest.

Hit Dice Recovery: At the end of a long rest, players regain spent Hit Dice up to a maximum of half their total Hit Dice (rounded down).

Standard Rule: Players can be revived through spells or magical effects.

Homebrew Rule: There is a 50% chance (roll of 11+ on a d20) that any revival attempt fails, regardless of the method used.

Increasing Difficulty: Each successful revival attempt increases the difficulty for future attempts by 5%. The second attempt requires a roll of 12+ on a d20 (55% chance), and so on.

True Resurrection: This spell ignores the chance of failure but can't be used again on the same target to bypass these rules.

When a character suffers a head injury, roll 1d8 to determine the effect and its duration (number of turns equal to the roll).

• 1-4: Concussion
  • Disadvantage on attack rolls, saving throws, and ability checks.
• 5-6: Blurred Vision
  • Disadvantage on attack rolls and Wisdom (Perception) checks relying on sight.
• 7: Dazed
  • Movement speed halved; cannot take reactions.
• 8: Knockout
  • Unconscious for 1d4 hours.

• Quick: Use an action to attempt revival (DC 15 Medicine check).
• Full Recovery: Rest or magical healing to reduce recovery time.

• Minor Strain: Disadvantage on Strength checks with the arm.
• Major Strain: Arm unusable; disadvantage on all Strength checks.
• Dislocated Shoulder: Arm unusable until reset.
• Broken Arm: Arm unusable; disadvantage on attacks and checks.

• Quick: Use an action to apply a sling or support.
• Full Recovery:
  • Minor Strain: Rest (1d4 days).
  • Major Strain: Medical attention or healing spells (1d6 days).
  • Dislocated Shoulder: DC 15 Medicine check or healing spell; sling for 1d4 days.
  • Broken Arm: Splint; rest for 1d4 weeks or magical healing.

• Sprained Ankle: Speed reduced by 10 feet.
• Deep Cut: Bleeding; speed reduced by 10 feet.
• Broken Leg: Speed reduced to 5 feet; cannot Dash.
• Severe Break: Cannot stand; can only crawl.

• Quick: Use an action to apply pressure; temporary splint takes 1 minute.
• Full Recovery:
  • Sprained Ankle: Rest (1d4 days).
  • Deep Cut: DC 15 Medicine check; heals over 1d6 days.
  • Broken Leg: Splint; no weight for 1d6 weeks or magical healing.
  • Severe Break: Long-term care or powerful healing; recovery in 1d6+2 weeks.

• Bruised Ribs: Disadvantage on Constitution checks and saves.
• Punctured Lung: Disadvantage on all actions; ongoing damage.
• Internal Bleeding: Ongoing damage each turn.
• Critical Organ Damage: Risk of death; severe ongoing damage.

• Quick: Use an action to reduce bleeding temporarily.
• Full Recovery:
  • Bruised Ribs: Rest (1d4 weeks).
  • Punctured Lung: Immediate medical attention; recovery in 1d4+1 weeks.
  • Internal Bleeding: Surgery (DC 20 Medicine check) or high-level healing.
  • Critical Organ Damage: Immediate magical healing required.

• Effect: Speed halved; cannot Dash.
• Prosthetic: Peg leg reduces speed reduction to 10 feet.

• Effect: Cannot use two-handed weapons; impaired fine motor skills.
• Prosthetic: May restore some functionality.

• Effect: Disadvantage on sight-based Perception checks and ranged attacks.
• Both Eyes Lost: Character is blinded.

• Damage: Lose 1d4 hit points at the start of each turn.
• Unconsciousness: At 0 hit points, begin death saving throws.

• Medicine Check: Action to stop bleeding (DC 10 + 2 × Severity Level); requires healer's kit or bandage.
• Magical Healing: Any healing spell stops bleeding.

• Action-Based Aid: Apply pressure, use a tourniquet, or create a splint.
• Limitations: Stabilizes but doesn't heal or remove penalties.

• Extended Care: Requires time, supplies, and a safe environment.
• Medicine Checks: DC 10 + 2 × Severity Level; success aids healing.
• Magical Healing: Spells like Cure Wounds expedite recovery.
• Professional Care: A healer improves chances of full recovery.

For determining DCs and treatment difficulty:

• Minor Injury: Severity Level 1
• Major Injury: Severity Level 2
• Severe Injury: Severity Level 3
• Critical Injury: Severity Level 4

Return to Rules