When D&D went to 5th Edition, they dropped the notion of negative hit points and came up with a new system called “death saving throws.”
Death Save Mechanics
Under this system, when you reach 0 HP, you fall unconscious and you begin making “death saving throws.” Each death save is a DC 10 check (no modifiers). It’s set up in a best-of-5 system. So, if you get 3 successes, you live; if you get 3 failures, you die. A creature who lives is stable at 0 hit points and needs time to recover. There’s an interesting little mechanic that instantly revives you with 1 HP when you roll a 20, and an opposite mechanic that gives you two death saves when you roll a 1. If you get hit, you lose 1 death save; criticals count as 2 hits.
Without getting into the minutiae, I submit that this is an improved system over negative HP. But, that doesn’t mean it’s perfect. What are some places we could improve the death saves system?
Being unconscious sucks in 5th Edition. It imposes a host of debilitating effects that render your character exceptionally vulnerable and useless during your turn (except for the opportunity to make a death save).
Being unconscious leaves you prone, which is a mixed bag of mostly bad tricks.
Being unconscious also imparts the incapacitated condition, which prevents you from taking actions or reactions.
These effects combine to create a system that is not very narratively satisfying on either side of the blade.
From the perspective of the fallen creature, they have been taken out of the game. They need to wait around for their turn to come around, and then all they can do is roll and pass. Even if they stabilize at 0 HP, they cannot make any difference in combat.
It would be more narratively satisfying if they could do something, even in a limited capacity. Crawl the last 5 feet towards the Big Red Button, utter your dying words, warn your allies, etc.
This would also give the baddies a reason to target fallen PCs, instead of forcing the DM to make the tough choice between breaking narrative to spare your character or being ruthless. The latter often feels like it’s being done by the DM and not the forces of evil.
Note: While I know not all foes will target a downed PC, it’s a reasonable tactic for any intelligent creature in a world with ubiquitous healing. To test this theory, add death saves and healing word to your monster stat blocks and see how the players respond. For better monster tactics, check out Keith Ammann’s work, The Monsters Know What They’re Doing.
The Coup de Grâce
The coup de grâce mechanic is a little odd, due to the interaction of a few rules:
- You still need to roll to hit a lifeless creature.
- But, you deal a critical hit when you do it.
- Close attacks against you are made with advantage.
- But, attacks at range are made normally. They would be made at disadvantage because you’re prone; they would be made at advantage because you can’t see.
This doesn’t fit with the way most people think this mechanic should be handled. In fact, less than 19% of players think that attacking an unconscious creature should follow this system:
Instead of attacking how the unconscious condition works, perhaps we can disguise its role in the death saves paradigm with a more clever mechanic. Players will be more satisfied with losing out on their desired auto-crit if the narrative supports that the fallen PC is still in the game.
Our solution is a progressive mechanic that uses all the same conditions, but imposes them with increasing level of severity. This adds additional drama to each death save not only due to the threat of dying, but due to the threat of not being able to help your party (and therefore yourself).
- 0 Failed Death Saves: Prone (Cannot Stand)
- 1 Failed Death Save: Incapacitated
- 3 Failed Death Saves: Dead
- More Fails than Saves: Unconscious
Falling prone at zero HP signals that you do not have any more energy to fight. You have collapsed from the toll the battle has taken on you. While you cannot stand, your speed does not become 0, so you can still crawl around and take actions and make attacks at disadvantage in a last-ditch effort to defend yourself from the onslaught of death. You may also want to have casters drop concentration at zero HP.
On your first failed save, you become incapacitated. You have lost the power to fight. You can no longer impact the battle in a meaningful way, but you can still crawl around, grab McGuffins, and tell your teammates how you really feel about them before your dying breath.
Any time you have more failed death saves than successful saves, you are unconscious. Your unresponsiveness serves as a mechanical signal to your team that you’re not doing so hot, whereas under the current system they have no idea how many death saves you’ve passed or failed without metagaming. This also adds additional drama to each roll, since you can slip in and out of consciousness. Imagine you’ve fallen unconscious, and you revive with one last gasp of air to take your final act. On the flip side of the narrative, bad guys now have a legitimate reason to ignore an unconscious creature, who is surely slipping towards death, compared with the usual 60% survival rate for a creature in death saves.
Once you roll three successes, you’re stuck with whatever conditions you had while you were in death saves (since the system can’t let you end unconscious, as per RAW). Imagine how this would lead to dramatic results, like the last living party member crawling back to town.
If you want some more death saves hacks, check out our alternative Meat Grinder Mode suggestions. Support us on the ThinkDM Patreon, where you can get additional content, early releases, and personalized help on your own design!