Variant Lingering Injuries Table

[Trask]

I find myself unsatisfied with the lingering injuries table in the DMG. I like the concept of a variable outcome and lingering penalties for being reduced to 0 HP, but having experienced it's effects as a player I found that true maiming wounds, like losing an arm or leg, really just aren't that fun in D&D's assumed mode of play. At low levels it essentially means the retirement of your character while at high levels its so easily fixed its a mere inconvenience and loses most of it's bite, so whats the point?. Also it can easily lead to absurd outcomes or occur with far too much frequency with the triggering events suggested by the DMG. (Suffering a critical, dropping to 0 HP, or failing a death saving throw by 5 or more.)

So I set about creating my own version of the table, substituting specific injuries for the more generally applicable exhaustion mechanic to represent a more abstract kind of injury, which I think fits better with D&D's abstract HP and abstract combat systems, while also relating severity to the amount of damage taken which helps create some kind of verisimilitude to (hopefully) prevent absurd outcomes.

Please tell me what you think!

Variant Rule: Knockout Roll

When you take damage that reduces you to 0 hit points, make a knockout roll, which is 1d20 minus the amount of damage taken in excess of 0 hit points. For example, if you had 10 HP and take 15 damage, roll 1d20-5. This roll does not benefit any other bonus. You can not go below 0 hit points.

Knockout Table
| d20 Roll | Effect |
|:---:|:---:|
| -40 or less | Dead and dismembered. You instantly die, and a body part is lost, or the body is partially or totally destroyed. 1d6; 1-2 (head), 3-4 (arm), 5-6 (leg) |
| -39 to -30 | Fatally Wounded. You are incapacitated, cannot move, and dying, and nothing other than a *Regenerate* spell can stabilize you. Suffer two levels of exhaustion and die in 1d6 minutes. |
| -29 to -20 | Badly Wounded. Become unconscious and dying, automatically suffer two death saving failures, two levels of exhaustion, and a nasty scar. |
| -19 to -10 | Wounded. Become unconscious and dying, automatically suffer one death saving failure, and gain two levels of exhaustion. |
| -9 to 0 | Badly Hurt. Become unconscious and dying, and suffer one level of exhaustion. |
| 1 to 4 | Hurt. Save vs. unconsciousness (Constitution, DC 20). Whether you succeed or fail, you are at 0 hit points but stabilized, and you suffer one level of exhaustion. | |
| 5 to 9 | Bloodied. Save vs. unconsciousness (Constitution, DC 15). Whether you succeed or fail, you are at 0 hit points but stabilized, and you suffer one level of exhaustion. |
| 10 to 14 | Battered. Save vs. unconsciousness (Constitution, DC 10). Whether you succeed or fail, you are at 0 hit points but stabilized, and you suffer one level of exhaustion. |
| 15 to 19 | Floored. Gain 1 hp, fall prone, drop anything you are holding in your hands, and lose concentration.
| Natural 20 | Adrenaline Rush. Regain 1d6 + your Constitution modifier hit points and take one action as a reaction.

[stoutstien]

One of my favorite lingering injuries that I use for when any player takes half or more damage equal to their total HP they must make a con check of 10. If they fail they cannot benefit from advantage on any attack roll or ability check until after the next long rest.

[Lupine]

I've noticed the same thing, actually. I play with that variant myself, and realized the possibility of huge problems when my warlock lost an eye, and I thought what it might have done to our Arcane Archer.

If I had my way, the results of knockout blows would be minor, something like reduced speed, or a -1 to damage. Something minor, but cumulative.
However, I would also like those effects to be permanent.
Sure, magical healing can reduce fleshy damage and exhaustion, but mass scale anatomical damage should not be able to be easily overcome, even with powerful magic. Society would change in astounding ways, if all injuries were irrelevant to the rich.
At the same time, I would like to see those effects be damaging, but not necessarily crippling. The result of this would be that characters would slowly become more feeble the more they get taken down, becoming slower, and less able to land meaningful hits, until the character retires due to physical disability. This would mirror real life too: if people could keep doing what they do, without the consequence of physical damage, then they would keep doing it for longer. ie, knights would keep fighting when their older, because they don't feel the disability that makes their self preservation instinct kick in.

TL:DR, Make lingering injuries be mechanically small, yet also permanent and cumulative, so that getting knocked out repeatedly has a significant impact to the character

[Boci]

Sure, magical healing can reduce fleshy damage and exhaustion, but mass scale anatomical damage should not be able to be easily overcome, even with powerful magic. Society would change in astounding ways, if all injuries were irrelevant to the rich.

What about regenerate? Its a 7th level spell, but "mass scale anatomical damage" is kinda what it deals with.

[Lupine]

What about regenerate? Its a 7th level spell, but "mass scale anatomical damage" is kinda what it deals with.

Sure. That could do it, especially since the name of the spell implies that it repairs damage by literally remaking the damaged area.
In addition, seventh level spells are cast by very few creatures, so it wouldn't cause enormous societal changes.