Damage & Healing

***Health Points***

A creature’s current health points can be any number from the creature’s health point maximum down to 0. This number changes frequently as a creature takes damage or receives healing. Whenever a creature takes damage, that damage is subtracted from its health points. The loss of health points does not affect a creature’s capabilities until the creature drops to 0 health points.

***Damage Rolls***

Each weapon, spell, and harmful monster ability specifies the damage it deals. You roll the damage die or dice, add any modifiers and apply the damage to your target. Magic weapons, special abilities, and other factors can grant a bonus to damage. With a penalty, it is possible to deal 0 damage, but never negative damage.

When attacking with a ***weapon***, you add your ability modifier, the same modifier used for the attack roll, to the damage. A ***spell*** tells you which dice to roll for damage and whether to add any modifiers.

If a spell or other effect deals damage to ***more than one target*** at the same time, roll the damage once for all of them.

***Multiple Damage Source Limitation***

Several sources of extra damage can be applied to damage rolls through abilities and feats. Whenever a creature makes a damage roll, that damage roll can not be augmented by more than three extra sources of damage from abilities and feats. For example, if a melee weapon attack would include extra damage from Rage [*Power*], Bruiser - Savage Aggression [*Tactics*], Fighting Style - Dueling, and the Risk and Reward option from the Great Weapon Master feat, the GM or the player must decide which three damage sources they like to apply to the attack. This decision can be declared after the attack has been declared a hit or a miss.

***Rolling 1 or 20 and Critical Hits***

If the d20 roll for an attack is a 1, the attack misses regardless of any modifiers or the target’s AV.

If the d20 roll for an attack is a 20, the attack hits regardless of any modifiers or the target’s AV. This is called a critical hit. When you score one you get to deal extra damage against the target. Roll all of the attack’s damage dice and add the maximum of each to the total. Then add any relevant modifiers as normal. If the attack involves other damage dice, you add the maximum of those dice twice as well. If an ability gives you extra damage dice on a critical, roll them and add them to the total.

Some abilities allow your character to acquire an improved critical range. This allows the player to score a critical hit on values lower than 20. A character’s critical range can never go below 18.

***Damage Types***

Different attacks, damaging spells, and other harmful effects deal different types of damage. Damage types have no rules of their own, but other rules, such as damage resistance, rely on the types.

The damage types follow, with examples to help a GM assign a damage type to a new effect.

* ***Acid***: The corrosive spray of a black dragon’s breath and the dissolving enzymes secreted by a black pudding deal acid damage.
* ***Bludgeoning***: Blunt force attacks - hammers, falling, constriction, and the like, deal bludgeoning damage.
* ***Cold***: The infernal chill radiating from an ice devil’s spear and the frigid blast of a white dragon’s breath deal cold damage.
* ***Fire***: Red dragons breathe fire, and many spells conjure flames to deal fire damage.
* ***Force***: Force is pure magical energy focused into a damaging form. Most effects that deal force damage are spells, including Magic Missile and Spiritual Weapon.
* ***Lightning***: A Lightning Bolt spell and a blue dragon’s breath deal lightning damage.
* ***Necrotic***: Necrotic damage, dealt by certain undead and a spell such as Chill Touch, withers matter and even the soul.
* ***Piercing***: Puncturing and impaling attacks, including spears and monsters’ bites, deal piercing damage.
* ***Poison***: Venomous stings and the toxic gas of a green dragon’s breath deal poison damage.
* ***Psychic***: Mental abilities such as a Tentainus’ psionic blast deal psychic damage.
* ***Radiant***: Radiant damage, dealt by a Flame Strike spell or an angel’s smiting weapon, sears the flesh like fire and overloads the spirit with power.
* ***Slashing***: Swords, axes, and monsters’ claws deal slashing damage.
* ***Thunder***: A concussive burst of sound, such as the effect of the Thunderwave spell, deals thunder damage.

***Damage Resistance and Vulnerability***

If a creature or an object has ***resistance*** to a damage type, damage of that type is halved against it. If a creature or an object has ***vulnerability*** to a damage type, damage of that type is doubled against it.

Resistance and then vulnerability are applied after all other modifiers to damage. Multiple instances of resistance or vulnerability that affect the same damage type count as only one instance.

***Healing***

Unless it results in death, damage isn’t permanent. Even death is reversible through powerful magic. Rest can restore a creature’s health points, and magical methods such as a *Cure Wounds* spell or a *Potion of Healing* can remove damage in an instant.

When a creature receives healing of any kind, hit points regained are added to its current health points. A creature’s health points can’t exceed its health point maximum, so any health points regain more than this number are lost.

A creature that has died can’t regain health points until magic such as the Revivify spell has restored it to life.

***Dropping to 0 Health Points***

When you drop to 0 health points, you either die outright or fall unconscious, as explained in the following sections.

***Instant Death***

Massive damage can kill you instantly. When damage reduces you to 0 health points and there is damage remaining, you die if the remaining damage equals or exceeds your health point maximum.

***Falling Unconscious***

If damage reduces you to 0 health points and fails to kill you, you fall unconscious. This unconsciousness ends if you regain any health points.

***Death Saving Throws***

Whenever you start your turn with 0 health points, you must make a special saving throw, to determine whether you creep closer to death or hang onto life. Unlike other saving throws, this one isn’t tied to any ability score.

Roll a d20, if the roll is 10 or higher, you succeed. Otherwise, you fail. A success or failure does not have any effect on its own. On your third success, you become stable. 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 health 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 health point.

***Damage at 0 Hit Points***: If you take any damage while you have 0 health points, you suffer a death saving throw failure. If the damage is from a critical hit, you suffer two failures instead. If the damage equals or exceeds your health points maximum, you suffer instant death.

**Stabilizing a Creature**

The best way to save a creature with 0 health points 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 unconscious creature and attempt to stabilize it, which requires a successful DC 10 Medicine (Cun) check.

A stable creature doesn’t make death saving throws, even though it has 0 health points, but it does remain unconscious. The creature stops being stable, and must start making death saving throws again if it takes any damage. A stable creature that isn’t healed regains 1 health point after 1d4 hours.

***Monsters and Death***

Most GMs have a monster die the instant it drops to 0 health points, rather than having it fall unconscious and make death saving throws. Mighty villains and special nonplayer characters are common 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 health points with a melee attack, the attacker can knock the creature out. The attacker can make this choice the instant the damage is dealt. The creature falls unconscious and is stable.

***Temporary Hit Points***

Some spells and special abilities confer temporary health points to a creature. Temporary health points aren’t actual health points; they are a buffer against damage, a pool of health points that protect you from injury. When you have temporary health points and take damage, the temporary health points are lost first, and any leftover damage carries over to your normal health points. Loss of temporary health points still triggers concentration checks if applicable.

Because temporary health points are separate from your actual health points, they can exceed your health point maximum. A character can, therefore, be at full health points and receive temporary health points.

Healing can’t restore temporary health points, and they can’t be added together. If you have temporary health points and receive more of them, you decide whether to keep the ones you have or to gain the new ones. If you have 0 health points, receiving temporary health points doesn’t restore you to consciousness or stabilize you. They can still absorb damage directed at you while you’re in that state, but only true healing can save you. Unless an ability that grants you temporary health points has a duration, they last until they’re depleted or you finish a long rest.