My 5e D&D Injury System

So a while back I made a post detailing my “Injury System” for Dungeons & Dragons 4th Edition.  It was roughly modeled after the Dragon Age: Origins injuries but without all the unruly book keeping that came with the ups and downs of temporarily changing ability scores.   Well, now a new edition of the game is upon us and I figured why the heck not update that old chart for the newest edition of the game.  It’s something to work with right?  While the new Dungeon Master’s Guide DOES have an Injury chart, it feels a bit severe and well – permanent – than some of my injuries. My injuries are things you see happening to inconvenience someone that they would sustain in a fight.  The official table in the book is like…  OH BAHAMUT YOU ARE #$%&ED UP!  I mean, losing body parts? Yeuch!  So here’s MY chart:

Roll 1d6
Roll Result Normal Effect Complicated Effect
1 Injured Arm Disadvantage on Strength Checks & Saves Disadvantage on Strength checks & saves. Disadvantage on Melee & Ranged attack rolls.
2 Injured Leg Disadvantage on Dexterity Checks & Saves. Speed reduced by 5 feet. Disadvantage on Dexterity check & saves. Speed reduced by 15 feet.
3 Cracked Skull Disadvantage on Wisdom and Intelligence Checks & Saves Disadvantage on Wisdom and Intelligence rolls. Including spell attack rolls. Can’t use spells that use concentration.
4 Cracked Rib Disadvantage on Constitution Checks & Saves.  Disadvantage on Constitution rolls. Vulnerable to Piercing, Slashing, and Bludgeoning damage.
5 Stomach Wound No CON modifier when you roll hit dice. No CON modifier when you roll hit dice. Hit dice roll is halved (round down.)
6 No Injury Sustained

As before, falling unconscious will result in one injury from the normal effect column (unless they roll a 6.) This injury can be treated in a town or city (DM Tip: feel free to charge a physician’s fee, or have a doctor ask a favor for treatment. Great story hook!) or by a DC 15 Wisdom (Medicine) check in the field and outside of combat.  However, if the players opt for the Wisdom (Medicine) check, a failure will result in the injury becoming complicated, and become the corresponded complicated effect.  A complicated injury MUST be treated in a town or city.

There’s also an alternate rule with these that I came up with after playing some test games of 5th edition and found that especially at low level things can be particularly deadly for players.   I’m sure that’s great for a lot of DMs and Players out there.  Lethal, deadly, and  risky – Yay.  Yea, that’s how a dungeon crawl SHOULD be.  But for me?  I prefer a good story.  So do my players.  So having characters drop like flies isn’t exactly a great feature for me and mine.  So I also added this:

Alternate Death Rules:  In the event that a character dies (by failing 3 death saves or taking lethal damage) they can try to be resuscitated after combat is over.  By making a Wisdom (Medicine) check with a DC 20, they can be brought back from the brink but automatically sustain 2 complicated injuries.  Roll against the injury chart above with 2d6 instead of 1.  The PC will sustain both injuries.  If one of the dice is a 6, reroll it until you get a 1-5.  If BOTH dice end up being rolled as 6s, then the PC has complications during the resuscitation and dies permanently.

Naturally you can play around with these making them worse or easier by switching around the DCs. Like a DC 10 to treat an injury and a DC 15 to resuscitate using those alternate dying rules. Or crank them up with you wanna get edgy with it.

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