Hitpoints and Injuries

Hit Points

Hit points are a representation of a character’s fatigue, and how much damage they are able to take before taking penalties and eventually going unconscious or dying. To calculate a character's HP, take their Constitution score and multiply it by their HP multiplier, then add any bonuses to HP that they possess.

Injury and Death

Loss of Hit Points
Over the course of a game a character may be in situations such as combat where they are at risk and have their hit points lowered by taking lethal damage. This damage represents everything from battle fatigue, small bruises or scratches, to life threatening mortal wounds.
Effects of Hit Point Damage
Damage slowly weakens a character, applying wounds as detailed below, until their current hit points reach 0 or lower. At 0 hit points, they gain the Disabled condition.
If their hit point total is below 0, but above half their Constitution plus Spirit score in negative hitpoints, they are considered Dying and have limited actions they may take.
When their negative Hit Point total equals half their Constitution plus Spirit score or greater they fall unconcious and are no longer able to act. If thier negative hit points reach the total of their constutition plus spirit score they must make a save or take a mortal wound. If a character ever reaches 3 mortal wounds they die.
Wounds Battle Wounds
At base, every 25% of HP lost applies a dire wound to the character, giving them a -1 penalty to all rolls. Some talents or abilities may modify when they gain wounds, or how many wounds they gain. Only lethal damage can trigger dire wounds, Nonlethal damage has no effect on dire wound thresholds.
Mortal Wounds
When a character's negative hit points reach the total of their constution plus spirit scores they must make a body save (DC 10 + 2 per save made that encounter + Critical Rating of the Effect that put the character in negative hitpoints OR the most recent attack) each round they are at this negative hitpoint ammount or lower or gain a mortal wound. A mortal wound is a grevious injury that inflicts a permanent 1 dire reduction on the character until they recieve apropriate treatment such as restoration or other similar effects. Once a character reaches 3 mortal wounds they die. These mortal wounds do not need to be gained in the same combat and any 3 mortal wounds accrued over time and not removed will kill a character.
Disabled (0 Hit Points)
When a character’s current hit point total reaches exactly 0, they are Disabled.
They gain the Disabled condition and can only take a single basic action each turn. For more information see the Conditions article.
Healing that raises a character’s hit points above 0 makes them fully functional again, just as if they had never been reduced to 0 or fewer hit points. However they still take any wound penalties that they possess until their hit points are above the threshold for that wound.
Dying (Negative Hit Points)
If a character’s hit point total is negative, but not equal to or greater than half their Constitution plus Spirit score, they are Dying. While dying the character may only take a single basic action each turn that is heavily limited. Any movement they take is reduced by half and while they make take a 5ft step it does consume this basic action. They may also not take any immediate or reactions while in this state. Strenous activity such as spellcasting requires concentration checks to perform while dying. While in this state they are considered defeated as long as they do not take any actions deemed offensive by the enemy. If any action is taken the character takes 1 point of damage.
Once a dying characters negative hit points reaches more than half the above threshold they immediately fall unconscious and can take no actions. While unconcious they continue to take 1 hit point of damage every round unless they make a successful stabilization check or are healed.
Dead
When a character’s current hit points drop to a negative amount equal to their Constitution plus Spirit score or lower, and they have 3 mortal wounds, they are dead. A character can also die from taking ability damage or suffering an ability drain that reduces their Attribute score to 0.
Certain types of powerful magic, such as raise dead and resurrection, can restore life to a dead character.

Damage Reduction

Characters are able to gain various types of Damage Reduction, this DR negates an amount of physical damage equal to the amount of DR that they possess on each hit. Damage reduction typically comes in five different categories that stack with each other. The five categories are as follows.
Innate Damage Reduction: Innate Damage Reduction typically refers to DR received from armor, shields, natural armor, talents, and some spells that manifest physical barriers. This type of damage reduction can be bypassed by any effect that ignores these sources, or by damage modifiers such as precision damage.
Alignment Damage Reduction: Alignment Damage Reduction typically refers to DR received from some racial and magical abilities. This type of damage reduction is typically listed as some form of the following, such as DR 5/Good. What this means is that this DR will reduce all incoming physical hits by 5 damage, unless the attack or weapon counts as good, at which point it bypasses this DR. If a character has multiple different alignment DRs they do not stack but simply take the highest applicable one at the time.
Typed Damage Reduction: Typed Damage Reduction typically refers to DR received from some racial and magical abilities. This type of damage reduction is only bypassed by a single type of physical damage (Bludgeoning, Piercing, Slashing), the type that bypasses will be listed with the DR. If a character has multiple typed DRs they do not stack but simply take the highest applicable one at the time.
Material Damage Reduction: Material Damage Reduction typically refers to DR received from some racial and magical abilities. This type of damage reduction is typically listed as some form of the following, such as DR 5/Silver. What this means is that this DR will reduce all incoming physical hits by 5 damage, unless the attack or weapon counts as silver, at which point it bypasses this DR. If a character has multiple different material DRs they do not stack but simply take the highest applicable one at the time.
Alchemical Damage Reduction: Alchemical Damage Reduction typically refers to DR received from some alchemical items and abilities. This type of damage reduction is usually temporary in nature and mimic the effects of other DR types, while still stacking with them.

Damage Reduction Application

When applying the effects of damage reduction to incoming damage each type of DR may only be applied once per hit. In addition the DR is typically applied in the order listed above, applying to the attacks base damage first before applying excess DR to additional damage such as from sneak attack or other abilities.

Stable Characters and Recovery

On the character’s next turn, after being reduced to negative hit points (but not dead), and on all subsequent turns, the character must make a DC 10 Constitution and Spirit Modifier check to become stable. The character takes a penalty on this roll equal to their negative hit point total. A character that is stable does not need to make this check. A natural 20 on this check is an automatic success. If the character fails this check, he loses 1 hit point. An unconscious or dying character cannot use any special action that changes the initiative count on which his action occurs.
Characters taking continuous damage, such as from an acid arrow or a bleed effect, automatically fail all Constitution checks made to stabilize. Such characters lose 1 hit point per round in addition to the continuous damage.
A dying character can be kept from losing any more hit points by making them stable with a DC 15 Heal check.
If any sort of healing cures the dying character of even 1 point of damage, they become stable and stop losing hit points.
Healing that raises the dying character’s hit points to 0 makes them conscious and Disabled. Healing that raises their hit points to 1 or more makes them fully functional again, just as if they had never been reduced to 0 or lower. A spellcaster retains the spellcasting capability they had before dropping below 0 hit points.
A stable character who has been tended by a healer or who has been magically healed eventually regains consciousness and recovers hit points naturally. If the character has no one to tend them, however, their life is still in danger, and may yet slip away.
Recovering with Help
One hour after a dying character becomes stable, but is also below 0 HP, the character must make a DC 10 Constitution check to become conscious. The character takes a penalty on this roll equal to their negative hit point total. Conscious characters with negative hit point totals are treated as disabled characters. If the character remains unconscious, they receive another check every hour to regain consciousness. A natural 20 on this check is an automatic success. Even if unconscious, the character recovers hit points naturally. They automatically regain consciousness when their hit points rise to 1 or higher.
Recovering without Help
A severely wounded character left alone usually dies. They have a small chance of recovering on their own. Treat such characters as those attempting to recover with help, but every failed Constitution check to regain consciousness results in the loss of 1 hit point. An unaided character does not recover hit points naturally. Once conscious, the character can make a DC 10 Constitution check once per hour, after resting for 8 hours, to begin recovering hit points naturally. The character takes a penalty on this roll equal to their negative hit point total. Failing this check causes the character to lose 1 hit point, but this does not cause the character to become unconscious. Once a character makes this check, they begin to heal naturally an amount equal to their Spirit and Constitution Modifier every 8 hours, and are no longer in danger of losing hit points naturally.

Healing

After taking damage, a character can recover lost hit points through various ways such as natural healing or through magical healing. In either case, a character can’t regain hit points past their normal maximum hit point total.
Natural Healing
Short Rest: This action can be taken after any encounter or activity that the DM believes is strenuous enough on the party. A short rest takes 10 minutes to complete, and allows a character to regain some spent resources. At base this gives them their Constitution mod in health, their Spirit mod in mana, and half their Con mod in stamina. They may only take one short rest per encounter or activity. The character may also regain resources of specific abilities if an ability gets resources during a short rest it will be listed in that ability.
Long Rest: This action can be taken once per day or more if the DM rules a character has done enough during the day, and requires 8 hours of rest with no strenuous activities. This fully refreshes most abilities and resources, as well as healing them 25% of their maximum hit points. If they are in a wilderness or potentially unsafe environment and choose to take watches during a long rest, they must account for the time spent keeping watch and extend their long rest so everyone gets a full 8 hours. For example, a 4 person party taking 2 hour watches must rest for 10 hours.
Extended Rest: This action is usually taken during down time or when forced to due to illness or major injury. Extended rest is when a character takes the rest action for 24 hours uninterrupted, at which point they heal double what they would have from long rest, in addition to what they would have from long rest. This healing cannot be doubled from long term care, however any other benefits of long term care still apply.
Long Term Care: If a character is being cared for by another character who successfully makes a DC 15 heal check while resting they double all the healing benefits of the rest. Long term care may also provide benefits on long term saves against things such as disease or poison. For more information see the Healing Skill.
Magical Healing
In the game there are many sources of Magical or Supernatural healing. This type of healing is instantaneous and does not require any checks beyond whatever check is required to activate the ability (For example spellcasting). The most common source of magical healing for living creatures is positive energy, however some creatures may be damaged by this source but may be healed by a different type of energy based on the creature. Magical healing typically heals all aspects of an injury such as scars or other such effects, however major injuries such as wounds, being put into the dying state, always leave behind these remnants unless using a more powerful form of magical healing.
Healing Limits
A character can never recover more hit points than they have lost, and their hit points may not go above their maximum hit points unless a special ability allows them to do so.
Healing Ability Damage
Over the course of an adventure a character may take damage directly to their attribute scores. This can come in one of two forms, Ability Damage and Ability Drain. Ability Damage is a temporary damage that will slowly heal over time, at a rate of 1 point per long rest. If a character has multiple ability scores that are damaged only 1 can heal at a time. Ability Drain is a more permanent damage type that can not be healed with natural rest, and must use magic or other abilities such as a potion or a high skilled healer. When ability drain is healed unless otherwise noted the healing only applies to one attribute score at a time.
Temporary Hit Points
Certain effects give a character temporary hit points. These hit points are in addition to the character’s current hit point total and any damage taken by the character is subtracted from these hit points first. Any damage in excess of a character’s temporary hit points is applied to their current hit points as normal. If the effect that grants the temporary hit points ends or is dispelled, any remaining temporary hit points go away. The damage they sustained is not transferred to the character’s current hit points.
When temporary hit points are lost, they cannot be restored as real hit points can, however new temporary hit points may be applied.
Increases and Decreases in Constitution Score and Current Hit Points
An increase or decrease in a character’s Constitution score, even a temporary one, can alter their hit points; these are not temporary hit points, and are treated as normal hit points for the duration of the effect.

Nonlethal Damage

Nonlethal damage represents harm to a character that is not life-threatening. Unlike normal damage, nonlethal damage is healed twice as quickly with rest.
Dealing Nonlethal Damage
Certain attacks deal nonlethal damage. Other effects, such as heat or being exhausted, may also deal nonlethal damage. When a character takes nonlethal damage, keep a running total of how much damage they have accumulated of that type separately from their hit point total. Do not deduct the nonlethal damage from their hit points. When a character’s nonlethal damage reaches a total equal to their current hit points, they fall unconscious , and when the non lethal damage reaches a total equal to their maximum hit points, any further nonlethal damage is taken as lethal damage.
Healing Nonlethal Damage
Healing Nonlethal damage is different depending on the source of healing. A character will naturally heal double a long rests amount of nonlethal damage with only 1 hour of rest. This does not apply any healing toward lethal damage, nor will it count towards the time needed for a long rest. Non Magical healing such as first aid from the heal skill only applies to nonlethal or lethal damage one at a time. Magical healing such as spells and magic items heals an equal amount to both lethal and nonlethal damage the character has suffered when applied .

Going Unconscious Multiple Times

If a character gets knocked below 0 HP multiple times in a single day between long rests, they have a chance of staying unconscious. A character can be knocked unconscious a number of times equal to their Constitution mod before being knocked unconscious for 1d4 hours. Certain spells that remove fatigue and spells like lesser restoration or higher can wake the character up, but if they get knocked unconscious again on that day, the amount of time goes up 1d4 hours per time knocked unconscious (minimum 1d4). Spells and other magical resources can only wake a character up based on their spell level or tier. Thus, a second level spell can wake a character up the first or second time after they fall unconscious, but not the third.