Hi everyone,

Here is a system I developed for changing the death saving throw mechanics:

Advanced Death Saving Throws - Injury Variant

What it achieves:

- Makes it harder to die in combat, while still preserving risk, albeit more granular

- As a drawback, sometimes when you stabilize, you will receive Lingering Injuries (roll table at DMG272)

- An average of 1 injury per stabilization (probabilistically)

- Gives PCs more reaction time by prolonging the average nr of turns for death saving throws (from an average of 4 turns, to about 7 turns)

- Monsters would need more hits to kill you while you are down and unconscious (and the DM won't feel that bad to hit a downed PC)

How it does it:

- Max failures to reach is now 7, instead of 3

- Max successes to reach is now 7, instead of 3

- Each time you roll the d20 death saving die, you also roll a d6 that we shall refer as the Intensity die

- The d20 die has normal rules, what is over 10 is a success, and under is a failure

- For each roll, half the Intensity die rounded down (minimum 1)

E.g: 

d6 = 6 -> 3

d6 = 4 or 5 -> 2

d6 = 3 or 2 or 1 -> 1

- When you roll, add the number of Successes/Failures equal to half the Intensity die value (rounded down, min 1)

E.g:

Roll d20=14, d6=2 -> 1 Success

Roll d20=9, d6=1 -> 1 Failure

Roll d20=17,d6=6 -> 3 Successes

Roll d20=3, d6=1 -> 1 Failure

- Rolling a 1 on a d20 (critical failure), you just double the number of Failures

- Rolling a 20 on a d20 (critical success), you just double the number of Successes, and when you finish, you get out at 1HP instead of just stable.

- Injury Rule: If you are to add more than 2 Failures in a turn, add Injuries instead

E.g. 

If you roll a d20=8, d6=6, which means to add 3 failure, you instead add 2 failures, and 1 injury 

If you roll a d20=1, d6=5, which means to add 2x2=4 failures (due to crit), you instead add 2 failures, and 2 injuries

- When a monster hits you while down, add a death saving Failure and roll a d6. If that d6 is a 6, then also add an injury.

- Tip: Track these using tokens like poker chips (3 colors, like red, black, green)

Simplified Death Saving Throws - Injury Variant

If you want something simpler, you can use the classic system, with the following two rules:

- When you roll a natural 1, instead of adding two failures, add 1 failure and 1 injury

- When a monster attacks you, roll a d6. If it is a 6, add an injury and a failure. If it is 1-5, add only an injury.

Extra recommendations:

Here are some rules that work really well with this advanced death throwing system.

Secret Death Saves Rule:

When a character does death saving throws, it does it in secret with the DM behind his screen, so the other party are in suspense. Rolling the die on these is quite fun for the DM and the player, and all the player needs to know is that the max to reach is 7, and that the red tokens represent injuries.

Resurection Variant: Mercer's Res Rules

This helps make resurections really rare. This is how our party likes to play. The injuries above add the level of risk, that is more gradual.

Injury Variant: Some injuries cannot be healed by simple healing spells

This helps some injuries require long rests, or priest interventions, to increase the stakes.

HP Scrubbing Nerf: When a character drops to 0HP and goes up, he receives 1 level of exhaustion

This is our preferred rule, to prevent 2H fighters charging in to be healed from 0 again and again.

I ran the numbers on this, and the times you get out of combat is similar to the classic system:

Simulation numbers:

- Classic death saving system: 10 times got out, 6 times died, average of 4 rounds

- Advanced death saving system: 10 times got out, 6 times died, average of 7.5 rounds, average of 1 injury

This is quite fun to do, and I recommend adapting the other rules of the game to fit in with these.

It is also quite intense to roll with the unconscious player behind the DM screen, and watch the party in horror.

Early deaths suck, especially for inexperienced players.

Let me know what you think and if you decide using it, follow this post so that you can leave feedback in the future.

Loop.