Injury, Death and Dying: Difference between revisions

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[[Category:Epic Path]]
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== Health ==
== Health ==
=== Hit Points ===
=== Hit Points ===
Hit points are the measure of your ability to continue fighting. They are not specifically a measure of how injured you are, in the sense that losing 10% of your hit points does not mean the loss of 10% of your body.  Instead, it represents a 10% reduction in your physical resources which permit you to fight, such as how much blood you've lost, how winded you are, etc.  At the end of the day, it is a very abstract value, and cannot be converted into a formula to decide how many of the 206 bones in your body (assuming your character is human) are broken at any given time.
Hit points are the measure of your ability to continue fighting...and...stay alive. They are not specifically a measure of how injured you are, in the sense that losing 10% of your hit points does not mean the loss of 10% of your body.  Instead, it represents a 10% reduction in your physical resources which permit you to fight and live, such as how much blood you've lost, how winded you are, etc.  At the end of the day, it is a very abstract value, and cannot be converted into a formula to decide how many of the 206 bones in your body (assuming your character is human) are broken at any given time.
 
Of course, once your hit points go below 0, your character is no longer able to fight.  


Of course, once your hit points go below 0, your character is no longer able to fight. And is at risk of death.


=== Temporary Hit Points ===
=== Temporary Hit Points ===
Certain effects give a character temporary hit points. These hit points are in addition to the character's current hit point total and any damage taken by the character is subtracted from these hit points first. Any damage in excess of a character's temporary hit points is applied to his current hit points as normal. If the effect that grants the temporary hit points ends or is dispelled, any remaining temporary hit points go away. The damage they sustained is not transferred to the character's current hit points.
Certain effects can grant a character temporary hit points. These hit points are in addition to the character's current hit point total and any damage taken by the character is subtracted from these hit points first. Any damage in excess of a character's temporary hit points is applied to their current hit points as normal. If the effect that grants the temporary hit points ends or is dispelled, any remaining temporary hit points go away. The damage they sustained is not transferred to the character's current hit points.


When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.
When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.
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While temporary hit points may have a duration lasting minutes or even hours, this is only in preparation of combat. Once an initiative roll is made (and combat begins), all temporary hit points currently applied or applied during the fight have their duration reduced to the end of combat (when the initiative order is dismissed) or until they are removed through damage, whichever is sooner.
While temporary hit points may have a duration lasting minutes or even hours, this is only in preparation of combat. Once an initiative roll is made (and combat begins), all temporary hit points currently applied or applied during the fight have their duration reduced to the end of combat (when the initiative order is dismissed) or until they are removed through damage, whichever is sooner.


If you already have temporary hit points, and a new effect would grant you more, they '''''do not''''' stack.  Instead, you either keep your current temporary hit points (if they are greater than the new source of temporary hit points), or you replace your temporary hit points with the new source of temporary hit points (if the new source is greater than your current temporary hit points).


== Types of Damage ==
== Types of Damage ==
=== Damage ===
=== Damage ===
Damage is the classic measure of injury, distress or debilitation that has been inflicted upon a creature as a result of some dangerous event or activity, such as getting hit by that heavy thing the troll is swinging around.  Damage is an abstract measure, much like hit points, which doesn't correlate to any specific amount of injury, blood loss or structural/skeletal damage to your character's form.  However, damage is used to describe the declining ability of your character to continue fighting.
Damage is the classic measure of injury, distress or debilitation that has been inflicted upon a creature as a result of some dangerous event or activity, such as getting hit by that heavy thing the troll is swinging around.  Damage is an abstract measure, much like hit points, which doesn't correlate to any specific amount of injury, blood loss or structural/skeletal damage to your character's form.  However, damage is used to describe the declining ability of your character to continue fighting.
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Damage can be healed with spells, but also heals naturally with rest.
Damage can be healed with spells, but also heals naturally with rest.


== Injury and Death ==
You can always tell, at a glance, the general health of any creature, among the following statuses: unharmed, injured, bloodied, staggered, unconscious, or dead.  This does not require a skill check, and anyone can do it.  It is only when you want to know the precise amount of hit points a creature has lost that a [[Heal]] or [[Divinity]] check is necessary.


=== Non-Lethal Damage ===
Note that none of these statuses are considered a 'condition', and they cannot be removed with abilities that normally remove conditions.
Non-lethal damage, which is also called subdual damage, works differently from normal damage.  Non-lethal damage is damage which is not intended to kill you, or is from a source which cannot kill you, but which can still impair your ability to continue fighting.  Examples can include punching someone with your fist without the improved unarmed strike feat, slashing someone with a (regular) whip, or striking someone with a sap.  Exhaustion and even exposure to heat or cold temperatures can also deal non-lethal damage.


When you take nonlethal damage, keep a running total of how much you've accumulated. Do not deduct the nonlethal damage number from your current hit points. It is not "real" damage. Instead, when your nonlethal damage equals your current hit points, you're staggered (see below), and when it exceeds your current hit points, you fall unconscious.
{{:Unharmed}}


Note that non-lethal damage interacts with temporary hitpoints in an interesting fashion, to wit:
{{:Injured}}


*Non lethal damage does NOT reduce the number of temporary hit points you have.
{{:Bloodied}}
*Non-lethal damage does NOT reduce the number of normal hit points you have, either.
*Non-lethal damage is recorded in a separate tally from normal damage, and if the amount of non-lethal damage you suffer exceeds your normal hitpoints, you are disabled, even if you have temporary hit points remaining.


Example: A sturdy fighter has 100 hit points.  His doughty warlord gives him 50 temporary hitpoints, and his monk friend playfully begins punching him, doing non-lethal damage, because monks can do that.
{{:Staggered}}


The first punch of the monk does 45 points of non-lethal damage. (Ow.)  The fighters temp hit points and normal hit points DO NOT CHANGE.  The warlord is frustrated, because this is bypassing her best mojo.
{{:Unconscious}}


The second punch does 56 points of damage.  The fighter now has 101 points of non-lethal damage and drops in his tracks, despite having 100 normal hitpoints and 50 temporary hit points on top of that.
{{:Dead}}


Example:  The fighter is laying there unconscious.  The warlord uses Encouraging Word and heals him for 50 hit points.  This healing, like all healing, reduces the amount of temporary damage and leaves the Fighter with 51 points of non-lethal damage.  The fighter wakes up, ready to go.
In addition, there are two statuses which can occur when a creature is unconscious: dying and stabilized.  Unlike the statuses above, these are not detectable from simple observation, but only through examination with either a [[Heal]] or a [[Divinity]] check.


Example: The Monk is tired and stops hitting the fighter.  The Rogue replaces him.  The Rogue doesn't do non-lethal damage, and stabs the hapless fighter for a whopping 80 points of damage.  This removes all fifty of the temporary hit points and does 30 hit points of real damage, leaving the fighter with 70 normal hitpoints and 51 points of non-lethal damage.  the fighter is able to continue.
{{:Dying}}


Example: The Monk, aghast at the deadly strike of the rogue, hits the fighter again, doing more non-lethal, before the rogue can go again.  The monk tanks the roll and does only 20 points of non-lethal.  This leaves the Fighter with 71 points of non-lethal damage, but because he only has 70 normal hitpoints due to the damage the rogue inflicted, down he goes again.  It's a hard day to be a Fighter.
{{:Stabilized}}


Example:  Exasperated, the Warlord uses Encouraging Word again, and cures the Fighter for another 50 hit points. This removes 50 hit points of non-lethal damage, leaving the Fighter with 21 points of Non-lethal, and also heals the Fighters normal hit points by 30, up to his normal maximum of 100.  The Fighter wakes up and decides to start using his shield, all this getting hit and waking up is starting to make him woozy....
==Detecting Afflictions==
Status conditions may or may not be noticeable with a visual inspection, depending upon how subtle or unusual they are in their application. Afflictions such as [[Prone]] are very obvious on a humanoid or other 'normally' shaped creature, but not so obvious on a fourteen-limbed aberration from another dimension and nearly impossible to tell on a worm.  


Other examples include Petrification, which may or may not be immediately obvious, depending on lighting, senses, etc.  Hindered and entangled are often very obvious (the victim is nearly buried in goop), but a mental entanglement may not be visible at all.


To reflect the vast array of potentials here, the GM must adjudicate what afflictions are visible, and which are not. In all cases, a Heal or Divinity check will reveal most afflictions, and other skill checks (such as Sense Motive, Barter, Knowledge, Local, Reason, etc.) may be situationally useful to reveal various subtle afflictions.


== Stabilizing the Dying ==
An adjacent ally can attempt to stabilize a dying character by making an [[Skill DC|Easy DC]] [[Heal]] check versus the level/CR of the dying character. If the check succeeds, the character's hit points are restored to 0, regardless of whatever negative total they previously sustained. The character replaces the 'dying' status with the 'staggered' status, but remains [[Prone]]. The character is at no further risk of dying until they take additional damage that reduces them below 0 hit points again. Note that [[Heal]] checks can be performed even if a character has stabilized on their own via a Death Check (see [[#Dying|Dying]], below).


; Nonlethal Damage with a Weapon that Deals Lethal Damage
If magical healing (e.g. a spell, scroll, potion, etc.) is used on a dying character instead of a [[Heal]] check, damage is restored from whatever negative value the character is currently at, but the character replaces the 'dying' status with the 'stabilized' status. While less efficient than performing a [[Heal]] check first, magical healing is a risk-free way to stop a character from potentially bleeding out due to failed Death Checks to stabilize.
: You can use a melee weapon that deals lethal damage to deal nonlethal damage instead, but you take a -4 penalty on your attack roll.


; Lethal Damage with a Weapon that Deals Nonlethal Damage
== Recovering Without Help ==
: You can use a weapon that deals nonlethal damage, including an unarmed strike, to deal lethal damage instead, but you take a -4 penalty on your attack roll.
A severely wounded character left alone usually dies. They have only a small chance of recovering on their own. While dying, every failed Death Check to stabilize brings them closer to death, and three such failed checks causes them to die.


When your nonlethal damage equals your current hit points, you're [[Staggered]]. You can only take a standard action or a move action in each round (in addition to free, immediate, and swift actions). You cease being staggered when your current hit points once again exceed your nonlethal damage.
Furthermore, even after they stabilize, an unaided character remains unconscious, and does not recover hit points naturally.  Instead, after a full night's rest (typically 8 hours), they must make a single Death Check (versus the same DC of 12). Failing this check causes the character to begin 'dying' again, starting up a new cycle of Death Checks to stabilize, and potentially resulting in their death. Characters that succeed on this check begin recovering hit points normally (at the rate of 1 hit point per character level per full day of rest), and are no longer in danger of needing to make additional Death Checks to stabilize.  


When your nonlethal damage exceeds your current hit points, you fall [[Unconscious]]. While unconscious, you are also [[Helpless]].
Unattended characters cannot gain the benefits of Long Term Care (see [[Heal]]), even if they have the [[Heal]] skill themselves.  They are simply too injured to provide that degree of care for themselves.


Spellcasters who fall unconscious retain any spellcasting ability they had before going unconscious.
==Types of Healing==
=== Instantaneous Healing ===
:Various abilities and spells can restore hit points.  Spells which result in an instant influx of hit points to the target creature are deemed Instantaneous Healing.  This does not refer to how long the spell takes to cast, only to the fact that the healing effect of the spell expends all of its beneficial effects on the target creature immediately upon the completion of casting.  Examples include [[Cure Light Wounds (Cleric Spell)]], [[Heal (Cleric Spell)]], [[Goodberry (Druid Spell)]], etc.


If a creature's nonlethal damage is equal to his total maximum hit points (not his current hit points), all further nonlethal damage is treated as lethal damage. This does not apply to creatures with regeneration. Such creatures simply accrue additional nonlethal damage, increasing the amount of time they remain unconscious.
:Some abilities are only triggered by instantaneous healing, such as the Fighter's tactic "Healer's Friend", or the [[Dweomermetals#Ambergold|ambergold]] dweomermetal (when used in armor or a shield).  In such cases, persistent healing (see below) does not trigger these abilities.


; Healing Nonlethal Damage
=== Persistent Healing ===
: Unlike normal damage, nonlethal damage is healed quickly with rest.  You heal nonlethal damage at the rate of 1 hit point per hour per character level. When a spell or ability cures hit point damage, it also removes an equal amount of nonlethal damage.
:Persistent healing is healing which occurs over a period of time. Healing from rest is considered persistent healing, but so is regeneration and fast healing. A warlord's [[Warlord#Exhortation_.28Ex.29|Exhortation]] ability or a bard's [[Song_of_Soothing_(Performance)|Song of Soothing]] are also persistent healing abilities. Even a spell which has a large healing effect the first round it is cast but then provides additional healing in future rounds is considered persistent healing.
 
=== Ability Damage ===
Diseases, poisons, spells, and other abilities can all deal damage directly to your ability scores. This damage does not actually reduce an ability, but it does apply a penalty to the skills and statistics that are based on that ability.
 
For every 2 points of damage you take to a single ability, apply a -1 penalty to skills and statistics listed with the relevant ability. If the amount of ability damage you have taken equals or exceeds your ability score, you immediately fall unconscious until the damage is less than your ability score. The only exception to this is your Constitution score. If the damage to your Constitution is equal to or greater than your Constitution score, you die. Unless otherwise noted, damage to your ability scores is healed at the rate of 1 per day to each ability score that has been damaged. Ability damage can be healed through the use of spells, such as lesser restoration.
 
:; Strength : Damage to your Strength score causes you to take penalties on Strength-based skill checks, melee attack rolls, and weapon damage rolls (if they rely on Strength). The penalty also applies to your Combat Maneuver Bonus (if you are Small or larger) and your Combat Maneuver Defense. A character with a Strength score of 0 is too weak to move in any way and is unconscious. Some creatures do not possess a Strength score and have no modifier at all to Strength-based skills or checks.
 
:; Dexterity : Damage to your Dexterity score causes you to take penalties on Dexterity-based skill checks, ranged attack rolls, initiative checks, and Reflex saving throws. The penalty also applies to your Armor Class, your Combat Maneuver Bonus (if you are Tiny or smaller), and to your Combat Maneuver Defense. A character with a Dexterity score of 0 is incapable of moving and is effectively immobile (but not unconscious).
 
:; Constitution : Damage to your Constitution score causes you to take penalties on your Fortitude saving throws. In addition, multiply your total Hit Dice by this penalty and subtract that amount from your current and total hit points. Lost hit points are restored when the damage to your Constitution is healed. A character with a Constitution score of 0 is dead.
 
:; Intelligence : Damage to your Intelligence score causes you to take penalties on Intelligence-based skill checks. This penalty also applies to any spell DCs based on Intelligence. A character with an Intelligence score of 0 is comatose.
 
:; Wisdom : Damage to your Wisdom score causes you to take penalties on Wisdom-based skill checks and Will saving throws. This penalty also applies to any spell DCs based on Wisdom. A character with a Wisdom score of 0 is incapable of rational thought and is unconscious.
 
:; Charisma : Damage to your Charisma score causes you to take penalties on Charisma-based skill checks. This penalty also applies to any spell DCs based off Charisma and the DC to resist your channeled energy. A character with a Charisma score of 0 is not able to exert himself in any way and is unconscious.
 
 
====Ability Score Penalties====
Some spells and abilities cause you to take an ability penalty for a limited amount of time. While in effect, these penalties function just like ability damage, but they cannot cause you to fall unconscious or die. In essence, penalties cannot decrease your ability score to less than 1.
 
 
====Ability Drain====
Ability drain actually reduces the relevant ability score. Modify all skills and statistics related to that ability. This might cause you to lose skill points, hit points, and other bonuses. Ability drain can be healed through the use of spells such as Restoration.
 
 
=== Energy Damage (Level Drain) ===
This attack saps a living opponent's vital energy and happens automatically when a melee or ranged attack hits. Each successful energy drain bestows one or more negative levels (the creature's description specifies how many). If an attack that includes an energy drain scores a critical hit, it bestows twice the listed number of negative levels. Unless otherwise specified in the creature's description, a draining creature gains 5 temporary hit points for each negative level it bestows on an opponent. These temporary hit points last for a maximum of 1 hour. Negative levels remain until 24 hours have passed or until they are removed with a spell such as restoration. If a negative level is not removed before 24 hours have passed, the affected creature must attempt a Fortitude save (DC 10 + 1/2 the draining creature's racial HD + the draining creature's Cha modifier; the exact DC is given in the creature's descriptive text). On a success, the negative level goes away with no harm to the creature. On a failure, the negative level becomes permanent. A separate saving throw is required for each negative level.
 
 
====Negative Levels====
 
For each negative level a creature has, it takes a cumulative -1 penalty on all ability checks, attack rolls, combat maneuver checks, Combat Maneuver Defense, saving throws, and skill checks. In addition, the creature reduces its current and total hit points by 5 for each negative level it possesses. The creature is also treated as one level lower for the purpose of level-dependent variables (such as spellcasting) for each negative level possessed. Spellcasters do not lose any prepared spells or slots as a result of negative levels. If a creature's negative levels equal or exceed its total Hit Dice, it dies.
 
A creature with temporary negative levels receives a new saving throw to remove the negative level each day. The DC of this save is the same as the effect that caused the negative levels.
 
Some abilities and spells (such as raise dead) bestow permanent level drain on a creature. These are treated just like temporary negative levels, but they do not allow a new save each day to remove them. Level drain can be removed through spells like Restoration. Permanent negative levels remain after a dead creature is restored to life. A creature whose permanent negative levels equal its Hit Dice cannot be brought back to life through spells like raise dead and resurrection without also receiving a restoration spell, cast the round after it is restored to life.
 
 
== Injury and Death ==
There are four states of critical injury:
 
; Disabled: Occurs at exactly 0 hit points. You gain the [[Staggered]] condition and can only take a single move or standard action each turn (but not both, nor can you take full-round actions). You can take move actions without further injuring yourself, but if you perform any standard action (or any other strenuous action) you take 1 point of damage after completing the act. Unless your activity increased your hit points, you are now at -1 hit points and dying.
 
; Dying: Occurs at any negative hit point total. You gain the [[Unconscious]] condition and can take no actions.  You take 1 point of damage at the start of each of your turns, and may roll a CON check to see if you stabilize. The DC of the stabilize check is 10 + your negative hit point total.  If you succeed on the roll, you cease losing hit points each round, but remain unconscious.  If you reach a negative hit point total of your CON stat (not stat mod) plus your level, you die.  Most NPC's die when their hit points go below zero, but some NPC's only die when they reach negative their CON value.  NPC's cannot stabilize without some special ability such as regeneration or assistance from an ally.


; Dead: When your character's hit points reach a negative total of your CON stat value plus your level, he dies. A character can also die from taking ability damage or suffering an ability drain that reduces his Constitution score to 0 (see Special Abilities).  Regular healing spells have no effect on dead characters.  Only certain types of powerful magic, such as raise dead and resurrection, can restore life to a dead character.  
: Fast healing is a fixed amount of healing that occurs each round during combat.  For example, "fast healing 5" would heal the owner of that ability by 5 points each round at the start of each of their turns, but only during combat.  Outside of combat (i.e. when there is no initiative order), fast healing does not operate, except in cases where the owner of the ability is suffering from any of [[impaired]], [[crippled]], or [[maimed]] conditions.  In that case, the fast healing works at a rate of its listed amount per 10 minutes, and only if the owner of the ability is resting.  Once the fast healing ability has healed enough to remove the impaired, crippled, or maimed status conditions, it ceases working until the next encounter begins.


; Stabilized: Can occur at any hit point value of 0 or less. A stabilized character is no longer dying. A stabilized character with negative hit points is still unconscious and cannot take any actions.  A stabilized character at 0 hit points has the Disabled condition (see above).  The stabilized condition can be achieved via a a successful CON check when dying, a First Aid check (Heal skill with DC 15), or via magical healing. See "Stabilizing the Dying" for more details.
: "Fast healing" and "regeneration" are identical terms.


: If a creature with fast healing is reduced to 0 or fewer hit points, or they are denied all actions during their turn, their fast healing ceases to function, and they must rely on other means of healing in order to recover. As soon as they are restored to at least 1 hit point, or are able to take any actions during their turn, fast healing begins functioning again.  Fast healing does not work if the creature is killed.


=== Stabilizing the Dying ===
=== Natural Healing ===
First Aid can be performed on a dying character by making a Heal check (DC 15). If the check succeeds, the character's hit points are restored to 0, regardless of whatever negative total they previously sustained. The character replaces the 'dying' status with the 'stabilized' status, regains consciousness and has the 'disabled' status as well. The character is at no further risk of dying until they take additional damage that reduces them below 0 hit points. Note that first aid checks can be performed even if a character has stabilized via a CON check.
:With a full night's rest (8 hours of sleep or more), you recover 1 hit point per character level. The 8 hours of sleep need not be consecutive, but need to occur within no greater than a 12 hour period, or your rest was too interrupted to receive any natural healing benefit from it.  Natural healing is considered a form of persistent healing, and therefore does not trigger abilities that refer to 'instantaneous healing'.
 
If magical healing (e.g. a spell, scroll, potion, etc.) is used on a dying character instead of First Aid, damage is restored from whatever negative value the character is currently at, but the character replaces the 'dying' status with the 'stabilized' status. While less efficient than performing First Aid first, magical healing is a dice-free way to stop a character from losing 1 hit point per round and potentially bleeding out. 
 
 
=== Recovering Without Help ===
A severely wounded character left alone usually dies. He has a small chance of recovering on his own. Treat such characters as those attempting to recover with help, but every failed Constitution check to regain consciousness results in the loss of 1 hit point. An unaided character does not recover hit points naturally. Once conscious, the character can make a DC 10 Constitution check once per day, after resting for 8 hours, to begin recovering hit points naturally. The character takes a penalty on this roll equal to his negative hit point total. Failing this check causes the character to lose 1 hit point, but this does not cause the character to become unconscious. Once a character makes this check, he continues to heal naturally and is no longer in danger of losing hit points naturally.
 
 
==Types of Healing==
 
=== Instantaneous Healing ===
Various abilities and spells can restore hit points.  Spells which result in an instant influx of hit points to the target creature are deemed Instantaneous Healing.  This does not refer to how long the spell takes to cast, only to the fact that the healing effect of the spell expends all of its beneficial effects on the target creature immediately upon the completion of casting.  Examples include Cure Light Wounds, Heal, Goodberries, etc.
 
Some abilities are only triggered by instantaneous healing, such as the Fighter's tactic "Healer's Friend".  In such cases, persistent healing (see below) does not trigger these abilities.
 
 
=== Persistent Healing ===
Persistent healing is healing which occurs over a period of time.  Healing from rest is considered persistent healing, but so is regeneration and fast healing.  A warlord's Exhortation ability or a bard's Soothing Performance are also persistent healing abilities.  Even a spell which has a large healing effect the first round it is cast but then provides additional healing in future rounds is considered persistent healing.  For example, applying the metamagic feat "Echoing Spell" to the 'Heal' spell would change it from an instantaneous healing ability to a persistent healing ability.
 


==== Natural Healing ====
:If you undergo complete bed rest for an entire day and night (24 hours consecutively), you recover twice as many hit points (typically twice your character level in hit points).
With a full night's rest (8 hours of sleep or more), you recover 1 hit point per character level. Any significant interruption during your rest prevents you from healing that night.


If you undergo complete bed rest for an entire day and night, you recover twice your character level in hit points.
:While not specifically related to hit point recovery, a full night's rest also restores 1 point of ability damage to each ability score which sustained damage. A full day's rest (24 hours) restores 2 points of ability damage to each ability score which sustained damage.  See [[Ability Damage]] for details.

Latest revision as of 04:39, 12 May 2021

Whoops....

Health

Hit Points

Hit points are the measure of your ability to continue fighting...and...stay alive. They are not specifically a measure of how injured you are, in the sense that losing 10% of your hit points does not mean the loss of 10% of your body. Instead, it represents a 10% reduction in your physical resources which permit you to fight and live, such as how much blood you've lost, how winded you are, etc. At the end of the day, it is a very abstract value, and cannot be converted into a formula to decide how many of the 206 bones in your body (assuming your character is human) are broken at any given time.

Of course, once your hit points go below 0, your character is no longer able to fight. And is at risk of death.

Temporary Hit Points

Certain effects can grant a character temporary hit points. These hit points are in addition to the character's current hit point total and any damage taken by the character is subtracted from these hit points first. Any damage in excess of a character's temporary hit points is applied to their current hit points as normal. If the effect that grants the temporary hit points ends or is dispelled, any remaining temporary hit points go away. The damage they sustained is not transferred to the character's current hit points.

When temporary hit points are lost, they cannot be restored as real hit points can be, even by magic.

While temporary hit points may have a duration lasting minutes or even hours, this is only in preparation of combat. Once an initiative roll is made (and combat begins), all temporary hit points currently applied or applied during the fight have their duration reduced to the end of combat (when the initiative order is dismissed) or until they are removed through damage, whichever is sooner.

If you already have temporary hit points, and a new effect would grant you more, they do not stack. Instead, you either keep your current temporary hit points (if they are greater than the new source of temporary hit points), or you replace your temporary hit points with the new source of temporary hit points (if the new source is greater than your current temporary hit points).

Types of Damage

Damage

Damage is the classic measure of injury, distress or debilitation that has been inflicted upon a creature as a result of some dangerous event or activity, such as getting hit by that heavy thing the troll is swinging around. Damage is an abstract measure, much like hit points, which doesn't correlate to any specific amount of injury, blood loss or structural/skeletal damage to your character's form. However, damage is used to describe the declining ability of your character to continue fighting.

The amount of damage dealt by any particular creature, weapon or object can vary significantly, and depends on a number of factors, such as the wielder's (or creature's) strength, level (or CR), and the type of weapon or object being used. Other sources of damage may include traps, falling from a height, spells, and even environmental effects such as extreme cold or heat.

When something damages your character, it follows the following steps:

  1. The damage is reduced by any factor you may have which reduces incoming damage by a percentage (such as insubstantial, which reduces damage by 50%)
  2. It is then reduced by any DR or ER which is applicable to the type of damage you have received
  3. The remainder is applied first to any temporary hit points your character may have
  4. Finally, the remaining damage is applied to your hit points.

Sometimes you multiply damage by some factor, such as on a critical hit. Roll the damage (with all modifiers) multiple times and total the results. Note that when you multiply damage more than once, each multiplier is added to the others, not multiplied. For example, if you critically hit with an axe, which does triple damage on a hit, and that damage is doubled for some secondary reason (such as a spell effect), the total multiple is x5, not x6. It's still going to hurt a LOT.

Damage can be healed with spells, but also heals naturally with rest.

Injury and Death

You can always tell, at a glance, the general health of any creature, among the following statuses: unharmed, injured, bloodied, staggered, unconscious, or dead. This does not require a skill check, and anyone can do it. It is only when you want to know the precise amount of hit points a creature has lost that a Heal or Divinity check is necessary.

Note that none of these statuses are considered a 'condition', and they cannot be removed with abilities that normally remove conditions.

Unharmed

Your current hit points are equal to your maximum hit points. The presence or absence of temporary hit points are not factored into this.

Injured

You are no longer at maximum hit points, but still have greater than half of your maximum hit points.

Bloodied

You have been reduced to half your maximum hit points (rounded down) or fewer. Some special abilities have greater effects against bloodied creatures. It is generally good form to announce when you become bloodied, and for the GM to announce when a monster has become bloodied.

Staggered

You are at exactly zero hit points. You may take a single move action or standard action each round (but not both, nor can you take full attack or full-round actions). You can still take free actions, but not swift or immediate actions. You can take move actions without further injuring yourself, but if you perform any standard action (or any other strenuous action), you take 1 point of damage after completing the act. Unless your activity increased your hit points, you are now at -1 hit points and dying.
Staggered does not apply to monsters, since they are slain when they reach 0 or fewer hit points. If a monster needs to remain alive for plot reasons, being reduced to exactly 0 hit points knocks the creature Unconscious.
In general, very few creatures are capable of inflicting the staggered condition as a special attack (though all of them can do it through damage, given the opportunity).

Unconscious

You are no longer capable of taking actions, and pass out. You fall Prone and become Helpless. Unconsciousness results from having your current hit points drop below zero, but not drop so low that you are dead (a character is dead when their current hit points are less than or equal to their Character Level + CON score (not modifier)). Unconscious includes all the penalties of Helpless and Prone, including susceptibility to coup-de-grace attacks. Unconscious characters cannot take any actions except some free actions (such as saving throws), though some free actions are simply not possible (such as speaking). The GM is the final arbiter of which free actions are permitted.
Any conditions you were suffering under, and any bonuses or buffs you have applied to you (as from spells) typically remain in effect while you are unconscious (though they may not provide any benefit until you regain consciousness, as with fast healing). Any time limit on the conditions or buffs (i.e. 'until the end of your next turn', etc.) still tick down while you are unconscious.
Generally, monsters die upon reaching negative hit points, rather than becoming unconscious. If a monster needs to fall unconscious for story reasons, they generally just stop accumulating damage once they reach 0 hit points.

Dead

When your character's hit points reach a negative total of its CON stat value (not your CON modifier) plus character level, it dies. A character can also die from certain status conditions, spells, or special abilities. Regular healing spells, such as Cure Critical Wounds (Bard Spell), and potions, scrolls or other effects which make use of healing spells, have no effect on dead characters. Furthermore, a character's fast healing (if any) ceases after death.
Only certain types of powerful magic, such as Raise Dead (Cleric Spell) and Resurrection (Cleric Spell), which specifically state they restore life to slain creatures, may be used to bring a character back from death. Note that being brought back to life via these sorts of spells does not cause you to become undead. Becoming undead requires a different sort of spell entirely — typically one which animates the corpse through the introduction of a new soul, or torments the departing soul into becoming a malevolent spirit.
Any status conditions, bonuses, buffs, or debuffs that a creature had applied to them are immediately removed when a creature dies, unless the ability which applied the condition or bonus explicitly states that it can persist even after a creature dies (such as Cursed, or Ability Drain).
Monsters typically die upon reaching 0 or fewer hit points.

In addition, there are two statuses which can occur when a creature is unconscious: dying and stabilized. Unlike the statuses above, these are not detectable from simple observation, but only through examination with either a Heal or a Divinity check.

Dying

Any time your hit points are at a negative number, but you are not instantly slain (i.e. your hit points are below zero, but not less than a negative total equal to your CON score (not modifier) + your character level), you are Dying. You gain the Unconscious condition and can take no actions. While dying, you must make a death check at the end of each of your turns, as a free action, to determine whether you continue to bleed out, or stabilize. A death check is resolved as follows:
Death Check: d20 (no modifiers*) vs. a DC of 12
* – rare modifiers to this check exist, such as from the Diehard feat.
If you succeed on the roll, you remain unconscious, but you stabilize and are no longer dying. If you fail the check three times in a row (over the course of three rounds), you die.
If you reach a negative hit point total of your CON stat (not stat mod) plus your level, you die. Most NPC's die when their hit points go below zero, but some NPC's only die when they reach negative their CON stat (not modifier) plus Level. NPC's cannot stabilize without some special ability such as regeneration or assistance from an ally.

Stabilized

Can occur at any hit point value of 0 or less. A stabilized character is no longer dying. A stabilized character with negative hit points is still Unconscious and cannot take any actions. The stabilized condition can be achieved via a successful Death Check to stabilize, a Heal check from an adjacent ally, or via magical healing. See "Stabilizing the Dying" for more details.

Detecting Afflictions

Status conditions may or may not be noticeable with a visual inspection, depending upon how subtle or unusual they are in their application. Afflictions such as Prone are very obvious on a humanoid or other 'normally' shaped creature, but not so obvious on a fourteen-limbed aberration from another dimension and nearly impossible to tell on a worm.

Other examples include Petrification, which may or may not be immediately obvious, depending on lighting, senses, etc. Hindered and entangled are often very obvious (the victim is nearly buried in goop), but a mental entanglement may not be visible at all.

To reflect the vast array of potentials here, the GM must adjudicate what afflictions are visible, and which are not. In all cases, a Heal or Divinity check will reveal most afflictions, and other skill checks (such as Sense Motive, Barter, Knowledge, Local, Reason, etc.) may be situationally useful to reveal various subtle afflictions.

Stabilizing the Dying

An adjacent ally can attempt to stabilize a dying character by making an Easy DC Heal check versus the level/CR of the dying character. If the check succeeds, the character's hit points are restored to 0, regardless of whatever negative total they previously sustained. The character replaces the 'dying' status with the 'staggered' status, but remains Prone. The character is at no further risk of dying until they take additional damage that reduces them below 0 hit points again. Note that Heal checks can be performed even if a character has stabilized on their own via a Death Check (see Dying, below).

If magical healing (e.g. a spell, scroll, potion, etc.) is used on a dying character instead of a Heal check, damage is restored from whatever negative value the character is currently at, but the character replaces the 'dying' status with the 'stabilized' status. While less efficient than performing a Heal check first, magical healing is a risk-free way to stop a character from potentially bleeding out due to failed Death Checks to stabilize.

Recovering Without Help

A severely wounded character left alone usually dies. They have only a small chance of recovering on their own. While dying, every failed Death Check to stabilize brings them closer to death, and three such failed checks causes them to die.

Furthermore, even after they stabilize, an unaided character remains unconscious, and does not recover hit points naturally. Instead, after a full night's rest (typically 8 hours), they must make a single Death Check (versus the same DC of 12). Failing this check causes the character to begin 'dying' again, starting up a new cycle of Death Checks to stabilize, and potentially resulting in their death. Characters that succeed on this check begin recovering hit points normally (at the rate of 1 hit point per character level per full day of rest), and are no longer in danger of needing to make additional Death Checks to stabilize.

Unattended characters cannot gain the benefits of Long Term Care (see Heal), even if they have the Heal skill themselves. They are simply too injured to provide that degree of care for themselves.

Types of Healing

Instantaneous Healing

Various abilities and spells can restore hit points. Spells which result in an instant influx of hit points to the target creature are deemed Instantaneous Healing. This does not refer to how long the spell takes to cast, only to the fact that the healing effect of the spell expends all of its beneficial effects on the target creature immediately upon the completion of casting. Examples include Cure Light Wounds (Cleric Spell), Heal (Cleric Spell), Goodberry (Druid Spell), etc.
Some abilities are only triggered by instantaneous healing, such as the Fighter's tactic "Healer's Friend", or the ambergold dweomermetal (when used in armor or a shield). In such cases, persistent healing (see below) does not trigger these abilities.

Persistent Healing

Persistent healing is healing which occurs over a period of time. Healing from rest is considered persistent healing, but so is regeneration and fast healing. A warlord's Exhortation ability or a bard's Song of Soothing are also persistent healing abilities. Even a spell which has a large healing effect the first round it is cast but then provides additional healing in future rounds is considered persistent healing.
Fast healing is a fixed amount of healing that occurs each round during combat. For example, "fast healing 5" would heal the owner of that ability by 5 points each round at the start of each of their turns, but only during combat. Outside of combat (i.e. when there is no initiative order), fast healing does not operate, except in cases where the owner of the ability is suffering from any of impaired, crippled, or maimed conditions. In that case, the fast healing works at a rate of its listed amount per 10 minutes, and only if the owner of the ability is resting. Once the fast healing ability has healed enough to remove the impaired, crippled, or maimed status conditions, it ceases working until the next encounter begins.
"Fast healing" and "regeneration" are identical terms.
If a creature with fast healing is reduced to 0 or fewer hit points, or they are denied all actions during their turn, their fast healing ceases to function, and they must rely on other means of healing in order to recover. As soon as they are restored to at least 1 hit point, or are able to take any actions during their turn, fast healing begins functioning again. Fast healing does not work if the creature is killed.

Natural Healing

With a full night's rest (8 hours of sleep or more), you recover 1 hit point per character level. The 8 hours of sleep need not be consecutive, but need to occur within no greater than a 12 hour period, or your rest was too interrupted to receive any natural healing benefit from it. Natural healing is considered a form of persistent healing, and therefore does not trigger abilities that refer to 'instantaneous healing'.
If you undergo complete bed rest for an entire day and night (24 hours consecutively), you recover twice as many hit points (typically twice your character level in hit points).
While not specifically related to hit point recovery, a full night's rest also restores 1 point of ability damage to each ability score which sustained damage. A full day's rest (24 hours) restores 2 points of ability damage to each ability score which sustained damage. See Ability Damage for details.
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