this post was submitted on 10 Jul 2023
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D&D Next - 5e Discussion
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As PC's progress, falling to 0HP in combat gets less and less meaningful. So I have used a rule that whenever a PC is at 0HP at the end of their turn, OR fail a death save, they take a level of exhaustion. It makes the 0HP yo-yo more dangerous, and makes it so "death" has some longer term consequences.
My group uses this, but with a separate temporary exhaustion (we call it Trauma) that goes away on a short rest. Still handily serves the purpose of discouraging yoyoing without being too punitive.
I tried this for a bit and everyone hated it. We were only like 6th level though.
A variant I considered but didn't try was to track how far into the negative you go. So if you get slammed by a dragon for 40 damage and you had 10/60 HP, now you're at -30. A basic healing word isn't going to wake you up.