Wounds

When playing in a "Brutal" level campaign, part of the difficulty comes from the wound system. Whenever you are "bloodied" (Knocked to half hit points) you roll for what "minor wound" you receive, and then the corresponding save vs the effect to determine its severity. Whenever you are reduced to 0 hp and are stabilized, you take a "major Wound" which persists longer and and has a more detrimental effect to your gameplay. If you stabilize through succeeding 3 death saving throws, you have disadvantage on the save against the wound. If stabilized through a DC 10 medicine check, or magical healing you roll the save normally. Being stabilized with a healers kit adds +1 to your save against the wound for every 2 the medicine check exceeds 10. Being stabilized with spare the dying grants you advantage on the save against a wound. If at any point, an unconscious creature fails a death save due to taking damage, they gain a cumulative -1 penalty to the next wound save they make upon stabilizing.
(Eg. Nirgel the human fighter is reduced to 0 hp and begins making death saving throws. One of the bandits hits Nirgel while unconscious with an arrow, inflicting him with a -1 penalty to the next wound saving throw he makes. Nirgel's Ally Kristof, uses his action to make a medicine check(with his healers kit) on Nirgel. Kristof rolls a 17 which stabilizes him, and provides a +3 bonus to his save against a wound. Upon being stabilized, Nirgel rolls a d12 to determine his wound (4: "Dazed") And then makes a Dexterity saving throw against it. Nirgel adds a +3 from Kristof's healers kit check, and subtracts -1 from the damage taken while dying earlier, for a net bonus of +2 on top of his normal dex save.

Whenever you would take a wound, you make a saving throw of the ability score shown on the table, The DC of the save is equal to the damage you took to reduce you to half hit points for minor wounds, and the damage you took to reduce you below 0 hp + 5 for major wounds. Some monsters have traits which allow them to interact with the wound system, which are listed here.
-Mauler: This monster only causes targets to roll 1d6 on the wounds table to determine what is dealt (Physical ability scores)
-Cynic: This monster only causes targets to roll 1d6+6 on the wounds table to determine what is dealt (Mental ability scores)
-Demoralizing Rend: On certain triggers such as Critical hits, exceeding AC by 5+, or even hitting all of the attacks in a turn.
-Brutal: Saves against wounds are increased either when provoked by the creature or in aura around the creature(Varies based on creature difficulty).
-Sadistic Tactics: When the monster would provoke a wound, it is not randomly rolled, and the monster may choose the "wound" option. Some monsters may only do this for either physical or mental stats, instead of the whole list.
Some Monsters may even have an ability that inflicts some other wound that may use certain wound rules but bend them such as being the result of attack results, or failed saves. Some monsters may inflict penalties or even alternate cure methods.

Healing and Curing Wounds

Creatures which take minor wounds that have the "until Cured" duration must have the wound specially looked at. A creature capable of casting Lesser restoration must spend a day of downtime, and the normal material cost to "cure" the wound. If this is an NPC, such as a priest or town cleric, they most often require payment to do so. Alternatively, if lesser restoration is cast during a long rest, the character suffering the wound can remake the save. At later levels, Greater restoration may be cast over the duration of a short rest (Instead of the caster taking the recuperate option) to cure the wound. The gm may determine that certain wounds, due to their severity or origin, need an additional material component that may add additional cost, or require a side quest to cure.

For major wounds that did not result in a lost appendage, A creature with "Greater Restoration" Can spend a day of downtime, allowing the creature to remake the save against one of their wounds. Creatures with major wounds have a catastrophic injury, often due to a missing body part. In order to Cure a major wound, the creature must have the greater restoration spell cast on them over the course of a downtime day. If the character gains a major wound which removes their limb, Severed limbs or appendages "Die" within 1 hour of being removed from the character and that point cannot be reattached, the effects of gentle repose can delay this. If the character does not have the missing limb present, The regenerate spell must be cast to heal the wound. This is a service that can be paid for in major towns, often their is a steep material cost, or retrieval quest.

Additional Factors

Non Humanoids: Creatures such as Warforged, autognomes and revenants do not have their severed limbs "Die", however they impose add an additional cost to any "curing" material components due to their differing nature from normal humanoids.

Minor Wounds Table

Wound Type (d12)	Save	Failure by 10+	failure by 9-5	Failure by 1-4	success by 1-4	Success by 5+
Broken or sprained Leg/Foot	Strength	-20ft movement speed until cured	half movement speed until cured	Half Movement speed until long rest	-10ft movement speed until long rest	-5ft Movement speed until short rest
Crushed/ Broken Hand	Strength	Reroll save, on failure 5+, treat as Lost hand major wound, otherwise treat as lost use of one hand until healed	lost use of one hand until healed	Items using hand suffer 1d4 penalty to all d20 checks, until healed	Items using hand suffer 1d4 penalty to all d20 checks, until long rest	Items using hand suffer 1d4 penalty to all d20 checks, until short rest
Deep Cut	Dexterity	Max Hp reduced by 3 * Level, until cured	Max Hp reduced by 3 * Level, until long rest	Max Hp reduced by 2 * Level, Until long rest	Max Hp reduced by Level, Until short rest	1d4 bleed damage
Dazed/ Blinded eye	Dexterity	Disadvantage on sight checks and attacks until Cured	Disadvantage on sight checks and attacks until Cured	Disadvantage on sight checks and attacks until long rest.	Disadvantage on sight checks and attacks until Short rest.	Disadvantage on sight checks until short rest.
Concussion	Constitution	Disadvantage on all concentration, and verbal rolls, until healed	Disadvantage on all verbal rolls, until healed	Disadvantage on all verbal rolls, until Long rest	Disadvantage on all verbal rolls, until Short rest	Disadvantage on all verbal rolls, for 1d4 rounds
Winded/damaged lung	Constitution	Constitution save DC 15 for verbal components and Breath held duration reduced to 12 seconds, until healed	Constitution save DC 15 for verbal components and Breath held duration reduced to 30 seconds, until healed	Constitution save DC 12 for verbal components and Breath held duration reduced to 30 seconds, until long rest	Breath held duration reduced to 30 seconds, until long rest	Dazed for 1 round
Memory Damage	Intelligence	Loss of random skill proficiency until healed	penalty d4 on random skill proficiency until healed	penalty d4 on random skill proficiency until Long rest	penalty d4 on random skill proficiency until Short rest	Disadvantage on next skill check within 1 minute
Broken Focus	Intelligence	Features that are repeated in a row are at disadvantage, Cannot take reactions until healed	Features that are repeated in a row are at disadvantage, Cannot take reactions until long rest	Features that are repeated in a row are done so at disadvantage until long rest	Cannot take reactions until Short rest	Cannot take reactions or concentrate for 1d4 rounds
Damaged/burst hearing	Wisdom	Deafened and disadvantage on saves against prone until Healed	Deafened until Healed	Deafened and disadvantage on saves against prone until Long rest	Deafened and disadvantage on saves against prone until Short rest	Deafened for 1d4 rounds
Trauma	Wisdom	Vulnerable to Psychic Damage, and disadvantage on fear saving throws/ lose immunity to fear until healed	Disadvantage on fear saving throws/ lose fear immunity, Take an additional d10 psychic whenever psychic damage is dealt until healed	Disadvantage on fear saving throws/ lose fear immunity, Take an additional d10 psychic whenever psychic damage is dealt until long rest	Disadvantage on fear saving throws/ lose fear immunity until long rest	Disadvantage on fear saving throws until long rest.
Dislocated/Broken Jaw	Charisma	Any attempt to speak or do verbal requirements deals 1d12 psychic damage until healed	Any attempt to speak or do verbal requirements deals 1d6 psychic damage until healed	Any attempt to speak or do verbal requirements deals 1d6 psychic damage until long rest	Silenced until short rest	Silenced for 1d4 rounds
Damaged self esteem	Charisma	Skill checks and attack rolls suffer d4 penalty until healed	Skill checks and attack rolls suffer d4 penalty until Long rest	Skill checks suffer d4 penalty until Long rest	Skill checks suffer d4 penalty until Short rest	No effect

Major Wounds Table

Wound Type (d12)	Save	Failure by 10+	failure by 9-5	Failure by 1-4	success by 1-4	Success by 5+
Lost toe-leg	Strength	Missing leg, Must make Jump to make any movement, Also must make Str save vs falling prone after each jump	Missing lower leg, Must make Jump to make any movement, Also must make Str save vs falling prone after movement	Missing foot, movement reduced to half, Must make Str save vs falling prone after movement	Lost toes, -10ft movement, disadvantage on shove checks and saves vs prone condition.	Lost toe, -5ft Movement speed Until healed
Lost Finger- arm	Strength	Lost arm, Cannot hold items with hand, disadvantage on all Str ability checks and saving throws.	Lost lower arm, Cannot hold items with hand, disadvantage on all Str ability checks	Lost hand, Cannot hold items with hand	Lost thumb, Must make Str save vs dropping held item whenever attempting to use.	Lost finger, Items using hand suffer 1d4 penalty to all d20 checks until healed
Internal Bleeding	Dexterity	Max Hp reduced by 5 * Level, Vulnerability to all damage. Until healed	Max Hp reduced by 4 * Level, take an additional 1d10 whenever taking damage Until healed	Max Hp reduced by 4 * Level, Until healed	Max Hp reduced by 2 * Level, Until healed	3d4 Bleed damage
Damaged/Lost eyes	Dexterity	Permanent blindness condition, until Healed	Permanent blindness condition, until Healed	Disadvantage on sight checks and attacks until Healed	Disadvantage on sight checks and attacks until Healed	Disadvantage on sight checks Until Long Rest
Brain Damage	Constitution	Cannot Concentrate on spells or effects until healed.	Concentration checks are vs the full damage, not half. Disadvantage on ability checks from spells Until healed	Concentration checks are vs the full damage, not half. Until Healed	Disadvantage on Concentration Checks until healed	Disadvantage on Concentration checks until Long rest
Crushed Lung/Punctured Lung	Constitution	Cannot Speak more than 3 Words Per round Constitution save DC 15 for verbal components and Cannot hold Breath, until healed	Cannot Speak more than 5 words per round, Constitution save DC 15 for verbal components and Breath held duration reduced to 30 seconds, until healed	Cannot Speak more than 5 words per round and Breath held duration reduced to 30 seconds, until long Healed	Breath held duration reduced to 30 seconds, until healed	Breath held duration reduced to 30 seconds, until long rest
Memory Loss	Intelligence	Loss of random proficiency(save, weapon, Skill, armor, tool) and two less prepared/known spell until healed	Loss of random Skill or save proficiency, and one less prepared/spell known until healed	Loss of random skill proficiency and one less prepared/known spell until healed	Loss of random skill proficiency until healed.	d4 penalty to random skill proficiency checks until healed.
Goldfish	Intelligence	Tasks that must be completed, or held over multiple rounds require a DC 10 intelligence check (Increasing DC by 2 for each subsequent check) to not forget what you were doing	Features that are repeated in a row are at disadvantage, Cannot take reactions Until Healed	Features that are repeated in a row are done so at disadvantage until Healed	Any tool or downtime check is rolled at disadvantage until healed	Any downtime activity is rolled at disadvantage until healed
Damaged/Deafened	Wisdom	Deafened and Automatically fail saves against effects that would move you until healed	Deafened and disadvantage on saves against effects that would move you until healed	Deafened and disadvantage on saves against prone until Healed	Deafened until Healed	Deafened until Long rest
PTSD	Wisdom	Vulnerable to Psychic Damage, Any fear effect you take is increased to the next higher version (Shaken -> Frightened -> Demented), Immunity to fear is stripped. until healed	Vulnerability to Psychic damage, Lose immunity to Fear, Disadvantage on saves against frightened until healed	Disadvantage on fear saving throws/ lose fear immunity ,Take an additional d10 psychic whenever psychic damage is dealt until healed	Disadvantage on fear saving throws/ lose fear immunity until Healed	Disadvantage on fear saving throws until healed
Broken jaw/ Lost tongue	Charisma	You are silenced until Healed.	Any attempt to speak or do verbal requirements deals 1d6 psychic damage until healed	You have disadvantage on all charisma ability checks, and any check that requires speaking until healed.	You have disadvantage on all charisma checks until healed	You have disadvantage on all charisma checks until a long rest
Broken/Shattered Will	Charisma	You automatically fail saves against charm effects, and treat verbal instructions as if they were the command spell until healed	You automatically fail saves against charm effects until healed	You have disadvantage on saves against charm effects until healed	You suffer a 1d4 penalty to saves against charm effects until healed	You suffer a 1d4 penalty to saves against charm effects until a long rest.