A Simple Injury System for D&D

Ever wish creatures and characters’ injuries actually mattered?  Hit points are an abstraction of wounds, physical toughness, weariness and even morale. 

Yet a specific injury system has always been difficult to implement without slowing the game down or creating an administrative nightmare. 

So what works andwhat doesn’t work?  Initially inspired by the Dragon Age video game’s injury system and now by Dragon Age II’s more streamlined version, here’s how you can adapt some easy-to-use injury rules to your D&D game.

Severe Injuries Only

These rules focus on severe injuries only, drawing a distinction between the “typical” minor bumps and bruises that hit points emulate.  This means severe injuries include things like broken legs or arms, savage eye gouges (or maybe something worse… Kill Bill, Vol. 2 anyone?), and severe concussions. 

For inspiration on injury flavor, look to sports’ most severe injuries – crushed, torn, broken, severed bone/muscle/tendon tend to work quite well.  (And yes, I’m lamenting my late round fantasy NBA steal Ricky Rubio’s recent ACL tear, can you tell?  Get well for next year my friend!)

Crits and Zero Hit Points Only

Severe injuries occur only when critically hit or taking damage that reduces a creature to 0 hit points or less.  This keeps injuries rare yet associated with the right kind of wounds at the right time.  Only big hits or killing blows should deliver the possibility of semi-permanent injury.  Yes, semi-permanent: D&D is a fantasy RPG after all, so truly permanent injuries that even magical healing can’t touch are no fun.  Instead, severe injuries should cost a significant amount of time to heal.  This way the adventure doesn’t have to come to a grinding halt.

Reduce Current and Maximum Hit Points

Severe injuries reduce current and maximum hit points.  This represents the lasting effect of significant injuries as they reduce overall hit points.  My recommendation?  10hp/tier of play so they scale and remain a significant yet rare part of the game.  For tracking simplicity, allow a maximum of two or three stacks per tier of play. 

Alternative, allow up to three stacks of severe injuries at heroic tier, up to two in paragon, and a maximum of one severe injury in epic tier.  By epic tier, an injury may reduce hit points by 30, but creatures are also more resilient overall.  This approach considers all of this.  Plus, from a tracking perspective, there’s always plenty to track besides injuries in paragon tier, never mind the mad administrative scramble that is epic tier. 

On a Faster Combat side note, I like that this added injury bonus damage – on either side – heightens the tension and increases the body count rate in combat.  Faster, more dramatic, more brutal combat!

Durations?  Read on…

Flavorful Conditions and Durations

Optionally, have the dazed, slowed, blinded and deafened conditions apply only to damage that reduces a creature below 0 hit points.  The condition selected should match any associated roleplay, type of attack, weapon type, and protective gear.   Use flavor text or attack descriptions or names as a guide.  For example, if your party’s badly wounded paladin is raked across the face by spiked gauntlets or a flurry of katar strikes, dropping her to below zero hit points, add in the blinded condition. 

These severe injury condition riders beg the question: what’s a good duration for them?  Use X number of short and/or extended rests here as a guide.  Once again, the cost of injuries should be time first and foremost, with a nagging condition or two also possible.  For the attack above, a short rest might be enough.  But for a giant’s maul that crushes the rogue’s leg right as the fight starts, you might decide it takes several extended rests – even weeks’ worth – before he’s no longer slowed by his broken leg. 

Talk with your players and decide if you want to include severe injury durations in addition to the standard hit point reduction.  Decide on a reasonable range of number of rests for a variety of injuries.  Then decide which injuries will have short rest durations only (i.e. blindness from a fireball), and which will have extended rest durations only (i.e. broken leg from a collapsing ceiling trap).  Make short rest durations injuries last 1d10 short rests, and make extended rest duration injuries last for 10d10 extended rests.

If you don’t use additional rider conditions on your severe injuries, then simply use the rest duration guidelines here.  The simplest approach is either 1-3 short rests or 1-3 extended rests duration for every injury, reversing the count per tier of play (i.e. 3 short rests at heroic, 2 at paragon, and 1 at epic).  If that’s not realistic enough or too silly, create your own ranges or go with DM’s discretion based on the attack, damage, weapon and equipment types as discussed above.

Go Break a Leg!

So there you have it – a simple injury system for D&D that’s easy to use and remember, with an optional layer of flavorful complexity.  Have you used injury systems in your D&D games before?  If not, give this one a try or simply share your thoughts on why you think this one could be a literally jaw-breaking hit in your games.

6 Responses to “A Simple Injury System for D&D”

  1. Dusty JohnsonNo Gravatar says:

    Love the idea. One more simple adjustment could be to injure a player where it really counts: healing surges. For each critical hit take d4 healing surges away for d10 extended rests; for drop below 0 effects take d10 surges for 6d10 extended rests. Here’s the kicker: if surges drop below 0 remaining, save or die.
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    • KilsekNo Gravatar says:

      Dusty, that is awesome idea on crits! How many sessions are there with characters hardly spending half their healing surges? Hitting the healing surge stock on a crit helps address that. And a sudden save or die on a crit is high-stakes, high drama, I like it! Death actually becomes something that can and will happen in 4e – brilliant!

  2. AlricNo Gravatar says:

    I like this idea a lot. Since everybody (including monsters) rolls a crit at least once in a while, it helps to make players a bit more wary of weaker monsters, who have the same potential to limit a hero’s recovery as anyone else. Using this approach, turning one’s back on a goblin cutter could have dire consequences, even for higher-level characters.
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    • KilsekNo Gravatar says:

      Welcome to Leonine Roar, Alric and thanks for your comment! Yes, this definitely makes monsters a threat at any PC level. If you like a bit more realism or a novel-style feel to dangers versus heroes who become superheroic or untouchable by some monsters at some point, this is one way to go!

  3. MarciaNo Gravatar says:

    And a sudden save or die on a crib is high-stakes, high drama,if surges drop below 0 remaining, save or die
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    • KilsekNo Gravatar says:

      Hi Marcia, thanks for your comment and welcome to Leonine Roar! Yes, that’s a great idea too for a bit more realism surrounding critical wounds – they could kill. Reminds of Death from Massive Damage (2e I believe) where you actually use to have to roll a % based on your Con or you’d die from one especially powerful attack.

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