Greetings D&D Beyond and Community,

I was re-reading the Suffocating section to make sure that I understood it fully, as our group will be going under water in the near future.

1st sentence: Hold Breath for 1+ CON Modifier.
2nd section: Once out of Breath, can survive for number of Rounds equal to CON Modifier, and after that drops to Zero HP and "is dying".
3rd section: Example using a player with a Constitution of 14, stating that it can Hold Breath for 3 Min and has 2 rounds to reach air once out of breath.

All of this is pretty straight forward, but I want to hear from DMs... How do you handle "is dying"?

After holding breath, then the number of rounds for trying to reach air, you are at Zero HP, Unconscious, and ... what?
Auto fail of first Death Save?
Auto Fail every Death Save until you reach air?

How do you DMs handle this?

Thank you in advance,

Cheers!

After holding breath, then the number of rounds for trying to reach air, you are at Zero HP, Unconscious, and ... what?
Auto fail of first Death Save?
Auto Fail every Death Save until you reach air?

It's covered in the rules you linked:

At the start of its next turn, it drops to 0 hit points and is dying, and it can't regain hit points or be stabilized until it can breathe again.

A dying creature makes a death saving throw at the start of each of its turns until it either fails three and dies, or is stabilized. Now given that a suffocating creature can't stabilize or regain hit points, should they succeed on three saving throws they'll immediately start dying again.

After "and is dying", it looks like some additional text was added at some point via errata which reads:  ", and it can't regain hit points or be stabilized until it can breathe again."

This is important because it impacts the death saving throw process. 

Quote from Davyd >>

A dying creature makes a death saving throw at the start of each of its turns until it either fails three and dies, or is stabilized. Now given that a suffocating creature can't stabilize or regain hit points, should they succeed on three saving throws they'll immediately start dying again.

The way that I interpret the situation, the creature just continues dying as opposed to start dying again.  I don't think that the count resets after 3 successes in this case.

From Chapter 9:  Combat --> Damage and Healing --> Dropping to 0 Hit Points:

If damage reduces you to 0 hit points and fails to kill you, you fall unconscious. This unconsciousness ends if you regain any hit points.

Whenever you start your turn with 0 hit points, you must make a special saving throw, called a death saving throw

On your third success, you become stable (see below). On your third failure, you die. The successes and failures don't need to be consecutive; keep track of both until you collect three of a kind. The number of both is reset to zero when you regain any hit points or become stable.

It would seem that since you cannot be stabilized while suffocating, the count is never reset.

While you normally keep track of death saving throw success and failure until you collect three of a kind, in case of suffocation, i keep track until 3 failure result in death, further success over 3 has no effect since you can't be stabilized until you can breathe again.

Thank you all for responding, and I just wanted to make sure that I am understanding your suggestions...

Davyd: On the chance that a player succeeds 3 death saves but is still under water, you just start the Death saves again from a clean slate.

up2ng: Follow the normal Death Saving Throw process and after 3 successes, the Death Saves do not reset, but what if the player is not out of the water yet?

Plaguescarred: Ignore all 'positive' Death Saves, and only track the 'negative' Death Saves until the creature is out of the water or dies.

Going back to the 3rd Section Example from my original post (from the PHB)... The character would have 3 minutes and 2 rounds to get to the surface, but if they didn't get to the surface, from what all three of you are saying, it sounds like, if (and that is a big 'IF') the player rolls lucky and keeps succeeding on their Death Saving Throws, they can stay there under the water until they are saved, or die... Correct?

That's correct it would eventually die but luck could keep one going for surprisingly longer than expected in some case.

I think that Plaguescarred and I have the same interpretation on this one.

Yes, you are correct -- the creature would not actually die until accumulating 3 failed death saving throws.  This could theoretically go on indefinitely (perhaps some sort of divine intervention), but statistically they would be unlikely to survive much beyond an additional minute or so.

For flavor, in the case of drowning (a subset of all suffocation situations), think of it like the creature can normally hold their breath for 3 minutes.  Then, at the moment when they are about to black out and desperately need to take a breath, they can will themselves to avoid taking this breath for an extra few seconds before actually blacking out.  Upon blacking out, they breathe in the water, fall unconscious and drop to 0 HP, probably sinking.  But, just like in real life the creature is not actually dead yet.  If someone pulls them out of the water right away and administers CPR to cause them to cough up the water, there is a brief window of time in which they can be saved.  In game, this chance would be during the death saving throw rounds, and the time allowed will vary, sort of like in real life.

Keep in mind that at this point, simply bringing that creature above water does not automatically save the creature.  It just means that breathing is now possible again.  This is just the prerequisite for that creature to be eligible to be stabilized or healed.  Until that happens, the creature is still following the rules for dropping to 0 HP, which means that it is still unconscious and is still making death saving throws.

At this point, at the moment when breathing becomes possible again, we would have to decide on an interpretation -- did the previous death saving throw successes accumulate?  The result becomes counter-intuitive:  If you were underwater in this state for longer, you would have a better chance of becoming stable at the moment of being pulled out of the water via successful death saving throws.

Another interpretation might be that successful death saving throws simply don't count and do not accumulate towards stabilization while suffocating since you cannot be stabilized while suffocating:

Roll a d20. If the roll is 10 or higher, you succeed. Otherwise, you fail. A success or failure has no effect by itself. On your third success, you become stable (see below).

You would have to read this rule in a certain way to arrive at the 2nd interpretation, but I don't think it's a totally invalid way to read it.  In addition, this rule might also indicate that you only become stable if you've just rolled a success -- you cannot just go back to previously accumulated successes to stabilize upon reaching air without rolling the dice at least one more time.

So, it seems that the DM might have about 3 possible ways to run this last part of the procedure depending on how they interpret the above rule and apply it to this situation.

It'd be so heartbreaking if a character made it that far while suffocating to die after being rescued out of water but failed to stabilize in time.

Thank you all for the help!

Cheers!!!