Kiren
2010-01-14, 10:20 PM
Welcome to my complete rewrite of my dnd 3.5 surgery mechanics designed to replace divine magic in terms of healing ailments, generally made for more realism and replacement of heal. This is a work in progress and much needs to be written, but I need fair, harsh criticism, im used to it from the last time I tried this. Good times.
Without further adue.
Dungeons and Dragons Field Issue Surgical Guide
-Alternatively DnD Surgery, dare I say second opinion?
Introduces alternate rules designed to replace the heal skill and divine magic as primary means of healing.
New classes
Surgeon Class
Alignment- Any
Hit Die- d6
Class Skills
The Surgeon's class skills (and the key ability for each skill) are Balance (Dex), Concentration (Con), Craft (Int), Surgery(Dex), Profession (Wis), Sleight of hand (Dex), Spot (Wis), Survival (Wis), Use rope(Dex),
Skill Points at 1st Level
(6 + Int modifier) ×4.
Skill Points at Each Additional Level
6 + Int modifier
{table=head] Level | Base Attack Bonus | Fort Save | Ref Save | Will Save | Special Abilities
1 | +0 | +0 | +2 | +0 | Surgical Training, Vital Strike +1d6
2 | +1 | +0 | +3 | +0 | Combat Surgery, Surgical Bonus Feat
3 | +1 | +1 | +3 | +1 | Mobile Healing
4 | +2 | +1 | +4 | +1 | Vital Strike +2d6
5 | +2 | +1 | +4 | +4 | Surgical Bonus Feat
6 | +3 | +2 | +5 | +2 | Death's Doctor
7 | +3 | +2 | +5 | +2 | Self Surgery, Vital Strike +3d6
8 | +4 | +2 | +6 | +2 | Poison Use
9 | +4 | +3 | +6 | +3 |
10 | +5 | +3 | +7 | +3 | Vital Strike +4d6
11 | +5 | +3 | +7 | +3 |
12 | +6/+1 | +4 | +8 | +4 |
13 | +6/+1 | +4 | +8 | +4 | Surgical Bonus Feat
14 | +7/+2 | +4 | +9 | +4 | Vital Strike +5d6
15 | +7/+2 | +5 | +9 | +5 |
16 | +8/+3 | +5 | +10 | +5 |
17 | +8/+3 | +5 | +10 | +5 | Surgical Bonus Feat
18 | +9/+4 | +6 | +11 | +6 |
19 | +9/+4 | +6 | +11 | +6 | Vital Strike +6d6
20 | +10/+5 | +6 | +12 | +6 | Surgical Bonus Feat[/table]
Thanks Elistan for the Table
Surgical Training-
Allows points to be spent in the surgery skill and enables the character to perform surgical techniques stated under the Surgical Mechanics section.
Vital Strike-
A surgeon can hit precisely on the vital areas of their enemies, when given the chance to target. The Surgeon’s attack deals extra damage any time her target would be denied a Dexterity bonus to AC (whether the target actually has a Dexterity bonus or not), or when the surgeon flanks her target. Should the surgeon score a critical hit with a sneak attack, this extra damage is not multiplied.
Ranged attacks can count as vital strikes.
A surgeon can sneak attack only living creatures with discernible anatomies—undead, constructs, oozes, plants, and incorporeal creatures lack vital areas to attack. Any creature that is immune to critical hits is not vulnerable to vital strikes. The surgeon must be able to see the target well enough to pick out a vital spot and must be able to reach such a spot. A surgeon cannot vital strike while striking a creature with concealment or striking the limbs of a creature whose vitals are beyond reach.
Surgical Bonus Feat-
On levels 2, 5 13, 17, and 20 the surgeon gains a new surgical bonus feat
Combat Surgery-
Combat surgery allows the surgeon to take combat actions during a round surgery is performed, if the surgeon has the appropritate action avalible.
Mobile Healing-
The surgeon can now move their patient during a round with surgery actions, at half the surgeons move speed.
Death's Doctor-
The surgeon knows all the vital points of the body and can strike down their targets accordingly, If a Surgeon studies his victim for 3 rounds and then makes a vital strike that successfully deals damage, the sneak attack has the additional effect of possibly either paralyzing or killing the target (surgeons’s choice). While studying the victim, the surgeon can undertake other actions so long as his attention stays focused on the target and the target does not detect the surgeon or recognize the surgeon as an enemy. If the victim of such an attack fails a Fortitude save (DC 10 + the surgeons’s class level + the surgeon's dex modifier) against the kill effect, she dies. If the saving throw fails against the paralysis effect, the victim is rendered helpless and unable to act for 1d6 rounds plus 1 round per level of the surgeon. If the victim’s saving throw succeeds, the attack is just a vital strike attack. Once the surgeon has completed the 3 rounds of study, he must make the death attack within the next 3 rounds.
If a death attack is attempted and fails (the victim makes her save) or if the assassin does not launch the attack within 3 rounds of completing the study, 3 new rounds of study are required before he can attempt another death attack.
Self Surgery-
A surgeon has achieved such expertise that they may perform surgery on themselves at a -10 to the surgery skill.
Poison Use
After exposure to many syringes and anestetics, you never risk accidently poisoning yourself.
Surgical Mechanics
New Skills-
Surgery (Dex, Trained only)
The surgery skill is used for treating wounds determining the effectiveness of surgical feats.
Multiple points increase your Accuracy and Cure rolls outcome, every 3 points adds 1 to the outcome.
Knocking out or Restraining the Patient
Getting cut with a knife without the ever-so helpful chemical adrenaline is not the best way to spend your day, this section includes how to successfully keep the patient knocked out and the surgeon not sued or beheaded for malpractice.
Magic/Psionics/Other
If Magic or Psionics is included within your campaign (surgery is designed for low magic settings or settings lacking divine magic), a patient may have their pain dulled (by a spell such as lullaby) or knock them out (by a spell such as sleep), but are not limited to these spells.
Physical Force
Dealing nonlethal damage accumulating to more then the patients hitpoint total will successfully knock them out. (Nonlethal damage recovers overtime, if the patient's nonlethal damage recovers enough, they will wake up mid surgery.
Rope/Held down
When you really can't be bothered.... well there is rope. Rope has no ability to dull pain but you can perform surgery without the patient moving and/or screaming, quite the harsh option considering physical force is free. A patient can also be held down with the use of at least one other person in a successful grapple with the patient.
Anesthesia
Anesthesia's effectiveness varies depending on the kind used, but is usually the most effective method. Check under new items for the Anesthetics. Administering a Anesthetic varies from Anesthetic to Anesthetic.
Going without
When their is really no other option, the surgeon can opt to do without. When going without anesthetic a surgeon takes a -10 penalty to the surgical skill.
Other
Other methods to knock out a patient are viable with DM permission.
Surgical Rolls
Accuracy Roll: An accuracy roll determines if a surgeon addresses a problem successfully, in order to begin treating a problem, the surgeon must roll against the Acuracy Difficulty (AD), accuracy rolls are done by D20, natural 20's will double the outcome of the cure roll. Missing a Accuracy roll requires the user to roll a Mishap. An Accuracy roll increases by 1 for every 3 points in the surgery skill.
Cure Roll: While a Accuracy Roll addresses a problem successfully, the Cure roll represents how much effect the treatment has. In order to advance to the next stage of the surgery, the surgeon must surpass the Cure Point Quota (from this point on CPQ) of the step. A cure roll using normal tools uses a 1d6 while a cure roll using makeshift tools will impose a -2 penalty on the roll and limit the dice to 1d4. A cure roll increases by 1 for every 3 points in the surgery skill.
Mishap Roll: A mishap happens and when it does, when an accuracy roll is failed roll 1d10 with a -1 bonus for every 4 points of con modifier of the patient and apply the outcome as vital damage. Using makeshift tools or going without any form of patient restraint adds one dice to the mishap roll, (so with both you have a 3d10 mishap roll, tough luck).
Vitals
Vitals represent the condition of the patients body during surgery, the base maximum vitals for a character is 100 with a +5 to every point of Constitution above 10, with a penalty of -5 for every point below 10 con. Characters recieve vital penalties depending on their hitpoint damage, from full to above 3/4th their is no penalty from hitpoints, from 3/4 to above 2/4 is a -10 vital reduction, 2/4 to above 1/4 is another -10 reduction, 1/4 to above 0 health is another -10, when a character has no hitpoints or negative hitpoints they have another reduction to vitals by -10. (a character with half health will have 80 starting vitals before the condition reduction while a character below 0 hitpoints will have 60 starting vitals). In addition to a hitpoint penalty from health, some conditions will also lower vitals, somethings are not easy to live through.When vitals drop to 0 the patient dies. A patient with no ailments (or benign) will recover vitals at a rate of 2 per hour.
Critical Injuries- Critical hit replacement
Critical injuries are aliments that require a surgeon (or magic) to fix. If a enemy rolls 20 and confirms with another 20 then the DM must roll 2d20 on the critical injury table below. (* When attacked by weapons or objects that are coated or dispense a harmful substance or ailiment, removal of that substance may be required*)
2: Fumble (Roll damage to self)
3-10: Nothing
11-12: Broken Bones ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
13-16: Lacerations (Roll 1d4 1-2: External, 3-4: Internal)
17-20: Foreign Object
21-26: Fracture ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
27-34: Loss of Minor body part (roll 1d10 1:Eye L. 2:Eye R. 3:Finger left hand 4:Finger Right 5:Toe L. 6:Toe R. 7-10: None lucky break.
35: Loss of majior body part (Roll 1d4 1=Arm left 2= Arm Right 3= Leg left 4= Leg right )
36-40: Roll twice and take both, reroll on conflicting injuries (Fracture and break on same limb, however a broken left arm and detatched left arm is compatible)
Alternatively you can use this variant for 1d6
1-2: Nothing
3-4: Fumble (Roll damage to self)
5-6: DM chosen injury
Complications-
If a Surgeon makes a mishap it adds one complication point, if enough complication points add up to match to complication quota further work will be required to correct surgeon error, this varies from ailiment to ailiment. If using makeshift tools add one more complication point for every mishap, another is the patient is unrestrained.
First Incision-
The first incision is required for most ailiments with internal damage, the accuracy difficulty for a first incision is 10 with a +1 for every point of natural armor the patient has. No cure roll is required and their is no chance of mishap.
Combat during Surgery-
A surgeon cannot perform combat actions and surgical actions in the same round, a patient can also not be moved and cannot attack during a round they are being performed on. The Combat Surgery ability enables these.
Procedures
Acid Draining
Procedure:
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Acid: Time: Standard Action AC: 8 CPQ: 4
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemorrhaging
Starting Vital Reduction: -5
Arrow/Bolt Removal
Cut off Edges of Arrow/Bolt: Time: Full Round Action AC: 14 CPQ: 6
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Broken Bones
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Bullet Removal (Shuriken/Pellets)
*Optional* First Incision (Internal Bullets only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Bullet: Time: Standard ActionAC: 14 CPQ: 3
OR
Removal of Shrapnel: Time: Full Round Action AC: 15 CPQ: 5
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Bullets only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Burn treatment
*Optional* First Incision (Internal Burns only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Eye Reattachment
*Reattached Eye need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the eye from the donor, whichever comes first.
Draining the Blood from socket: Time: Standard Action AC: 8 CPQ: 4
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Reconnect eye to socket: Time: Full Round Action AC: 13 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -20
Lacerations
*Optional* First Incision (Internal Lacerations only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Lacerations only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -5
Foreign Object Removal
*Optional* First Incision (Internal Objects only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Objects only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Infection
*Optional* First Incision (Internal Infection only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Hemorrhaging
Starting Vital Reduction: -15
Hemorrhaging
*Optional* First Incision (Internal Hemorrhaging only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Hemorrhaging only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection
Starting Vital Reduction: -5
Limb Reattachment
*Reattached limb need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the limb from the donor, whichever comes first.
Wrap remaining attached limb tight: Time: Swift Action AC:0 CPQ:1
Stitch the limb onto body: Time: Full Round Action AC: 15 CPQ: 5
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Wrap the wound lightly: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging, loss of limb
Starting Vital Reduction: -20
Limb Removal
Wrap limb tight: Time: Swift Action AC:0 CPQ:1
Remove the limb: Time: Full Round action AC:14 CPQ:6
Stitch extra skin to remaining limb: Time: Full Round Action AC: 14 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging
Starting Vital Reduction: -0
Surgery End Vital Reduction: -20 (1d10 days)
Mummy rot Curing
Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
OR
External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stiching the wound: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, hemoraging,
Starting Vital Reduction: -10
Parasite Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Parasites:
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Poison draining
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Poison: Time: Standard Action AC: 8 CPQ: 4
Removal of Poisoned tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stiching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemoraging
Starting Vital Reduction: -5
Slimy doom Removal
Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
OR
External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -15
Tumor Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Cut tissue to tumor: Time: Swift Action AC: 10 CPQ: 2
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Cut around tumor: Time: Standard Action AC: 10 CPQ: 4
Removal of Tumor: Time: Standard Action AC: 8 CPQ: 2
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -10
New Items
Its widely known that knives hurt, especially the dull and blood covered ones, when performing surgery remember a couple of things, a surgeon is half skill, half equipment, the second one is never let the barbarian handle the surgery.
Tools
Surgeons Kit
Cost:100 Gp
Removes all penalties for working with improvised tools, since.... well these are the tools.
Trauma Kit
Cost:500 Gp
+ 2 bonus to surgery skill, removes all penalties for working with improvised tools
Knock out Anesthetics
Mild Anesthetic
Cost: 20 Gp per dose
Knocks out a medium individual for an hour, (small: 2 hours, Large: Half an hour)
Dwarven water
Cost: 50 Gp per dose
Knocks out a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)
Dwarven king's brew
Cost: 80 Gp per dose
Knocks out a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)
Pain Dulling Anesthetics
Minor Pain killer
Cost: 40 Gp per dose
Dulls the pain for a medium individual for an hour, (small: 2 hours, Large: Half an hour)
Medium: -2 to hit roll (Small: -4, Large: -1)
Medium pain killer
Cost: 100 Gp per dose
Dulls the pain for a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)
Medium: -4 to hit roll (Small: -8, Large: -2)
Heavy pain killer
Cost: 160 Gp per dose
Dulls the pain for a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)
Medium: -8 to hit roll (Small: -16, Large: -4)
New Feats
Surgical Feats
Part time surgeon (Surgical)
Effect: Allows a non surgeon to take ranks in surgery and perform surgery.
Without further adue.
Dungeons and Dragons Field Issue Surgical Guide
-Alternatively DnD Surgery, dare I say second opinion?
Introduces alternate rules designed to replace the heal skill and divine magic as primary means of healing.
New classes
Surgeon Class
Alignment- Any
Hit Die- d6
Class Skills
The Surgeon's class skills (and the key ability for each skill) are Balance (Dex), Concentration (Con), Craft (Int), Surgery(Dex), Profession (Wis), Sleight of hand (Dex), Spot (Wis), Survival (Wis), Use rope(Dex),
Skill Points at 1st Level
(6 + Int modifier) ×4.
Skill Points at Each Additional Level
6 + Int modifier
{table=head] Level | Base Attack Bonus | Fort Save | Ref Save | Will Save | Special Abilities
1 | +0 | +0 | +2 | +0 | Surgical Training, Vital Strike +1d6
2 | +1 | +0 | +3 | +0 | Combat Surgery, Surgical Bonus Feat
3 | +1 | +1 | +3 | +1 | Mobile Healing
4 | +2 | +1 | +4 | +1 | Vital Strike +2d6
5 | +2 | +1 | +4 | +4 | Surgical Bonus Feat
6 | +3 | +2 | +5 | +2 | Death's Doctor
7 | +3 | +2 | +5 | +2 | Self Surgery, Vital Strike +3d6
8 | +4 | +2 | +6 | +2 | Poison Use
9 | +4 | +3 | +6 | +3 |
10 | +5 | +3 | +7 | +3 | Vital Strike +4d6
11 | +5 | +3 | +7 | +3 |
12 | +6/+1 | +4 | +8 | +4 |
13 | +6/+1 | +4 | +8 | +4 | Surgical Bonus Feat
14 | +7/+2 | +4 | +9 | +4 | Vital Strike +5d6
15 | +7/+2 | +5 | +9 | +5 |
16 | +8/+3 | +5 | +10 | +5 |
17 | +8/+3 | +5 | +10 | +5 | Surgical Bonus Feat
18 | +9/+4 | +6 | +11 | +6 |
19 | +9/+4 | +6 | +11 | +6 | Vital Strike +6d6
20 | +10/+5 | +6 | +12 | +6 | Surgical Bonus Feat[/table]
Thanks Elistan for the Table
Surgical Training-
Allows points to be spent in the surgery skill and enables the character to perform surgical techniques stated under the Surgical Mechanics section.
Vital Strike-
A surgeon can hit precisely on the vital areas of their enemies, when given the chance to target. The Surgeon’s attack deals extra damage any time her target would be denied a Dexterity bonus to AC (whether the target actually has a Dexterity bonus or not), or when the surgeon flanks her target. Should the surgeon score a critical hit with a sneak attack, this extra damage is not multiplied.
Ranged attacks can count as vital strikes.
A surgeon can sneak attack only living creatures with discernible anatomies—undead, constructs, oozes, plants, and incorporeal creatures lack vital areas to attack. Any creature that is immune to critical hits is not vulnerable to vital strikes. The surgeon must be able to see the target well enough to pick out a vital spot and must be able to reach such a spot. A surgeon cannot vital strike while striking a creature with concealment or striking the limbs of a creature whose vitals are beyond reach.
Surgical Bonus Feat-
On levels 2, 5 13, 17, and 20 the surgeon gains a new surgical bonus feat
Combat Surgery-
Combat surgery allows the surgeon to take combat actions during a round surgery is performed, if the surgeon has the appropritate action avalible.
Mobile Healing-
The surgeon can now move their patient during a round with surgery actions, at half the surgeons move speed.
Death's Doctor-
The surgeon knows all the vital points of the body and can strike down their targets accordingly, If a Surgeon studies his victim for 3 rounds and then makes a vital strike that successfully deals damage, the sneak attack has the additional effect of possibly either paralyzing or killing the target (surgeons’s choice). While studying the victim, the surgeon can undertake other actions so long as his attention stays focused on the target and the target does not detect the surgeon or recognize the surgeon as an enemy. If the victim of such an attack fails a Fortitude save (DC 10 + the surgeons’s class level + the surgeon's dex modifier) against the kill effect, she dies. If the saving throw fails against the paralysis effect, the victim is rendered helpless and unable to act for 1d6 rounds plus 1 round per level of the surgeon. If the victim’s saving throw succeeds, the attack is just a vital strike attack. Once the surgeon has completed the 3 rounds of study, he must make the death attack within the next 3 rounds.
If a death attack is attempted and fails (the victim makes her save) or if the assassin does not launch the attack within 3 rounds of completing the study, 3 new rounds of study are required before he can attempt another death attack.
Self Surgery-
A surgeon has achieved such expertise that they may perform surgery on themselves at a -10 to the surgery skill.
Poison Use
After exposure to many syringes and anestetics, you never risk accidently poisoning yourself.
Surgical Mechanics
New Skills-
Surgery (Dex, Trained only)
The surgery skill is used for treating wounds determining the effectiveness of surgical feats.
Multiple points increase your Accuracy and Cure rolls outcome, every 3 points adds 1 to the outcome.
Knocking out or Restraining the Patient
Getting cut with a knife without the ever-so helpful chemical adrenaline is not the best way to spend your day, this section includes how to successfully keep the patient knocked out and the surgeon not sued or beheaded for malpractice.
Magic/Psionics/Other
If Magic or Psionics is included within your campaign (surgery is designed for low magic settings or settings lacking divine magic), a patient may have their pain dulled (by a spell such as lullaby) or knock them out (by a spell such as sleep), but are not limited to these spells.
Physical Force
Dealing nonlethal damage accumulating to more then the patients hitpoint total will successfully knock them out. (Nonlethal damage recovers overtime, if the patient's nonlethal damage recovers enough, they will wake up mid surgery.
Rope/Held down
When you really can't be bothered.... well there is rope. Rope has no ability to dull pain but you can perform surgery without the patient moving and/or screaming, quite the harsh option considering physical force is free. A patient can also be held down with the use of at least one other person in a successful grapple with the patient.
Anesthesia
Anesthesia's effectiveness varies depending on the kind used, but is usually the most effective method. Check under new items for the Anesthetics. Administering a Anesthetic varies from Anesthetic to Anesthetic.
Going without
When their is really no other option, the surgeon can opt to do without. When going without anesthetic a surgeon takes a -10 penalty to the surgical skill.
Other
Other methods to knock out a patient are viable with DM permission.
Surgical Rolls
Accuracy Roll: An accuracy roll determines if a surgeon addresses a problem successfully, in order to begin treating a problem, the surgeon must roll against the Acuracy Difficulty (AD), accuracy rolls are done by D20, natural 20's will double the outcome of the cure roll. Missing a Accuracy roll requires the user to roll a Mishap. An Accuracy roll increases by 1 for every 3 points in the surgery skill.
Cure Roll: While a Accuracy Roll addresses a problem successfully, the Cure roll represents how much effect the treatment has. In order to advance to the next stage of the surgery, the surgeon must surpass the Cure Point Quota (from this point on CPQ) of the step. A cure roll using normal tools uses a 1d6 while a cure roll using makeshift tools will impose a -2 penalty on the roll and limit the dice to 1d4. A cure roll increases by 1 for every 3 points in the surgery skill.
Mishap Roll: A mishap happens and when it does, when an accuracy roll is failed roll 1d10 with a -1 bonus for every 4 points of con modifier of the patient and apply the outcome as vital damage. Using makeshift tools or going without any form of patient restraint adds one dice to the mishap roll, (so with both you have a 3d10 mishap roll, tough luck).
Vitals
Vitals represent the condition of the patients body during surgery, the base maximum vitals for a character is 100 with a +5 to every point of Constitution above 10, with a penalty of -5 for every point below 10 con. Characters recieve vital penalties depending on their hitpoint damage, from full to above 3/4th their is no penalty from hitpoints, from 3/4 to above 2/4 is a -10 vital reduction, 2/4 to above 1/4 is another -10 reduction, 1/4 to above 0 health is another -10, when a character has no hitpoints or negative hitpoints they have another reduction to vitals by -10. (a character with half health will have 80 starting vitals before the condition reduction while a character below 0 hitpoints will have 60 starting vitals). In addition to a hitpoint penalty from health, some conditions will also lower vitals, somethings are not easy to live through.When vitals drop to 0 the patient dies. A patient with no ailments (or benign) will recover vitals at a rate of 2 per hour.
Critical Injuries- Critical hit replacement
Critical injuries are aliments that require a surgeon (or magic) to fix. If a enemy rolls 20 and confirms with another 20 then the DM must roll 2d20 on the critical injury table below. (* When attacked by weapons or objects that are coated or dispense a harmful substance or ailiment, removal of that substance may be required*)
2: Fumble (Roll damage to self)
3-10: Nothing
11-12: Broken Bones ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
13-16: Lacerations (Roll 1d4 1-2: External, 3-4: Internal)
17-20: Foreign Object
21-26: Fracture ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
27-34: Loss of Minor body part (roll 1d10 1:Eye L. 2:Eye R. 3:Finger left hand 4:Finger Right 5:Toe L. 6:Toe R. 7-10: None lucky break.
35: Loss of majior body part (Roll 1d4 1=Arm left 2= Arm Right 3= Leg left 4= Leg right )
36-40: Roll twice and take both, reroll on conflicting injuries (Fracture and break on same limb, however a broken left arm and detatched left arm is compatible)
Alternatively you can use this variant for 1d6
1-2: Nothing
3-4: Fumble (Roll damage to self)
5-6: DM chosen injury
Complications-
If a Surgeon makes a mishap it adds one complication point, if enough complication points add up to match to complication quota further work will be required to correct surgeon error, this varies from ailiment to ailiment. If using makeshift tools add one more complication point for every mishap, another is the patient is unrestrained.
First Incision-
The first incision is required for most ailiments with internal damage, the accuracy difficulty for a first incision is 10 with a +1 for every point of natural armor the patient has. No cure roll is required and their is no chance of mishap.
Combat during Surgery-
A surgeon cannot perform combat actions and surgical actions in the same round, a patient can also not be moved and cannot attack during a round they are being performed on. The Combat Surgery ability enables these.
Procedures
Acid Draining
Procedure:
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Acid: Time: Standard Action AC: 8 CPQ: 4
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemorrhaging
Starting Vital Reduction: -5
Arrow/Bolt Removal
Cut off Edges of Arrow/Bolt: Time: Full Round Action AC: 14 CPQ: 6
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Broken Bones
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Bullet Removal (Shuriken/Pellets)
*Optional* First Incision (Internal Bullets only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Bullet: Time: Standard ActionAC: 14 CPQ: 3
OR
Removal of Shrapnel: Time: Full Round Action AC: 15 CPQ: 5
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Bullets only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Burn treatment
*Optional* First Incision (Internal Burns only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Eye Reattachment
*Reattached Eye need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the eye from the donor, whichever comes first.
Draining the Blood from socket: Time: Standard Action AC: 8 CPQ: 4
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Reconnect eye to socket: Time: Full Round Action AC: 13 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -20
Lacerations
*Optional* First Incision (Internal Lacerations only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Lacerations only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -5
Foreign Object Removal
*Optional* First Incision (Internal Objects only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Objects only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15
Infection
*Optional* First Incision (Internal Infection only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Hemorrhaging
Starting Vital Reduction: -15
Hemorrhaging
*Optional* First Incision (Internal Hemorrhaging only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Hemorrhaging only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection
Starting Vital Reduction: -5
Limb Reattachment
*Reattached limb need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the limb from the donor, whichever comes first.
Wrap remaining attached limb tight: Time: Swift Action AC:0 CPQ:1
Stitch the limb onto body: Time: Full Round Action AC: 15 CPQ: 5
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Wrap the wound lightly: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging, loss of limb
Starting Vital Reduction: -20
Limb Removal
Wrap limb tight: Time: Swift Action AC:0 CPQ:1
Remove the limb: Time: Full Round action AC:14 CPQ:6
Stitch extra skin to remaining limb: Time: Full Round Action AC: 14 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging
Starting Vital Reduction: -0
Surgery End Vital Reduction: -20 (1d10 days)
Mummy rot Curing
Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
OR
External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stiching the wound: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, hemoraging,
Starting Vital Reduction: -10
Parasite Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Parasites:
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10
Poison draining
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Poison: Time: Standard Action AC: 8 CPQ: 4
Removal of Poisoned tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stiching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemoraging
Starting Vital Reduction: -5
Slimy doom Removal
Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
OR
External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -15
Tumor Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Cut tissue to tumor: Time: Swift Action AC: 10 CPQ: 2
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Cut around tumor: Time: Standard Action AC: 10 CPQ: 4
Removal of Tumor: Time: Standard Action AC: 8 CPQ: 2
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -10
New Items
Its widely known that knives hurt, especially the dull and blood covered ones, when performing surgery remember a couple of things, a surgeon is half skill, half equipment, the second one is never let the barbarian handle the surgery.
Tools
Surgeons Kit
Cost:100 Gp
Removes all penalties for working with improvised tools, since.... well these are the tools.
Trauma Kit
Cost:500 Gp
+ 2 bonus to surgery skill, removes all penalties for working with improvised tools
Knock out Anesthetics
Mild Anesthetic
Cost: 20 Gp per dose
Knocks out a medium individual for an hour, (small: 2 hours, Large: Half an hour)
Dwarven water
Cost: 50 Gp per dose
Knocks out a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)
Dwarven king's brew
Cost: 80 Gp per dose
Knocks out a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)
Pain Dulling Anesthetics
Minor Pain killer
Cost: 40 Gp per dose
Dulls the pain for a medium individual for an hour, (small: 2 hours, Large: Half an hour)
Medium: -2 to hit roll (Small: -4, Large: -1)
Medium pain killer
Cost: 100 Gp per dose
Dulls the pain for a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)
Medium: -4 to hit roll (Small: -8, Large: -2)
Heavy pain killer
Cost: 160 Gp per dose
Dulls the pain for a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)
Medium: -8 to hit roll (Small: -16, Large: -4)
New Feats
Surgical Feats
Part time surgeon (Surgical)
Effect: Allows a non surgeon to take ranks in surgery and perform surgery.