Death and Exhaustion
These optional rules build upon the foundation for the dying and exhaustion mechanics presented in the Player's Handbook. Use these rules if you want to have a harder game in which being reduced to 0 hit points has more severe and lasting consequences
Exhaustion
Similarly to the base rules exhaustion represents your character's physical weariness and the ways to acquire it remain the same, however there is now more levels of exhaustion. Replace the description of the effects of exhaustion found in page 291 of the player's handbook with the effects listed in the following table.
| Level | Effect |
|---|---|
| 1 | Disadvantage on mental ability checks |
| 2 | Disadvantage on physical ability checks |
| 3 | Speed halved |
| 4 | Disadvantage on attack rolls |
| 5 | Disadvantage on saving throws |
| 6 | Hit point maximum halved |
| 7 | Speed reduced to 0 |
| 8 | Death |
Everything else about the condition remains unchanged from its original description.
Art Credits
Wizards of the Coast
Death
The mechanics for dying remain the same to those presented in the section titled "Dropping to 0 Hit Points" found in page 197 of the Player's Handbook, with the following exceptions.
Instant Death
You can add the following modification to this section. "If a creature falls unconscious as a result of being reduced to 0 hit points while they have 7 levels of exhaustion they instantly die at the beginning of their next turn unless their exhaustion level is reduced by 1 or more"
Death Saving Throws
You can add the following modification to this section. Increasing the DC. Whenever a creature with one or more levels of exhaustion makes a death saving throw the DC of the saving throw increases by 1 for every level of exhaustion the creature has. For example, if a player character with two levels of exhaustion was reduced to 0 hit points, the DC for the death saving throws would be 12 instead of 10.
Stabilizing a Creature
You can add the following modification to this section. "You can use your action to administer first aid to an unconscious creature adjacent to you and attempt to stabilize it with a Wisdom (Medicine) check, the DC of which equals 10 + the creature's level of exhaustion"
Recovering From 0 Hit Points
This is a new segment which you can add to the "Dropping to 0 Hit Points" section. When a creature at 0 hit points recovers at least 1 hit point or becomes stable they immediately gain 1 level of exhaustion.
