When you drop to 0 hit points, you either die outright or fall unconscious, as explained in the following sections.
Massive Damage
Massive damage can kill you instantly. When damage reduces you to 0 hit points and there is damage remaining, you die if the remaining damage equals or exceeds your hit point maximum.
For example, a cleric with a maximum of 12 hit points currently has 6 hit points. If she takes 18 damage from an attack, she is reduced to 0 hit points, but 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.
Brink of Death
If damage reduces you to 0 hit points and fails to kill you, you immediately gain 2 levels of exhaustion and begin
dying instead. The
dying conditions ends if you regain any hit points.
Death Saving Throws
While
dying, you must make a special saving throw at the start of each of your turns called a death saving throw. Death saving throws determine whether you creep closer to death or hang onto life. Unlike other saving throws, this one isn't tied to any ability score. You are in the hands of fate now, aided only by spells and features that improve your chances of succeeding on a saving throw.
Roll a d20. If the roll is 10 or higher, you succeed. Otherwise, you fail. A success or failure has no effect by itself. On your third success, you are no longer
dying, you fall unconscious instead, immediately begin a short rest, ending your unconsciousness when you regain any hit points. On your third failure, you die. The successes and failures don't need to be consecutive; keep track of both until you collect three of a kind. The number of both is reset to zero when you regain any hit points or become stable.
Rolling 1 or 20. When you make a death saving throw and roll a 1 on the d20, it counts as two failures. If you roll a 20 on the d20, you regain 1 hit point.
Damage at 0 Hit Points. If you take any damage while you have 0 hit points, you suffer a death saving throw failure and gain 1 level of exhaustion. If the damage is from a critical hit, you suffer two failures instead, alongside gaining 1 level of exhaustion. If the damage equals or exceeds your hit point maximum, you suffer instant death.
Last Stand
While
dying, you can cease clinging to life at any time, and instead take one desperate final turn, interrupting the current turn. During this extra turn, you can ignore any condition effects that would prevent you from taking an action (such as being incapacitated). Immediately after taking this turn, you die.
Stabilizing a Creature
The best way to save a
dying creature is to heal it. If healing is unavailable, the creature can at least be stabilized so that it isn't killed by a failed death saving throw.
You can use your action to administer first aid to an
dying creature, which requires a successful DC 10 Wisdom (Medicine) check. On a success, the creature is no longer
dying, falls unconscious instead, and immediately begins a short rest, ending the unconsciousness when it regains any hit points. The creature begins
dying, and must start making death saving throws again, if it takes any damage while unconscious at 0 hit points.
Monsters and Death
Most monsters die the instant they drops to 0 hit points, rather than falling unconscious and make death saving throws.
Mighty villains and special nonplayer characters may be exceptions; the GM might have them fall unconscious and follow the same rules as player characters.
Knocking a Creature Out
Sometimes an attacker wants to incapacitate a foe, rather than deal a killing blow. When an attacker reduces a creature to 0 hit points with a melee attack, the attacker can knock the creature out, causing it to fall unconscious . The attacker can make this choice the instant the damage is dealt.
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