Advanced Injury System (5e Variant Rule)

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Advanced Injury System[edit]

This rule set is meant to help incorporate specifics into the system and replaces basic hit points and death mechanics with a more detailed yet streamlined method of determining weapon and armor damage, combat fatigue, permanent and temporary injuries, and gives different weapons more unique advantages and disadvantages.

Replacement Stats for Hit Points[edit]

Hit points works differently with this system that helps the damage and injuries become less arbitrary and vague. Due to the changes, feats, skills, abilities and spells may also need to be altered, especially those involving critical hits. This is based off of a variant rule in Unearthed Arcana for 3rd and 3.5 edition and translates well into 5th Edition.


What normally would be considered your "Hit Points" is now called Vitality and is determined as normal (ie hit die + con modifier + misc). Vitality represents your energy level in combat. When you lose vitality, you are exerting yourself, causing fatigue. When your Vitality reaches 0, you are essentially staggered and struggling. As a result, if your Vitality reaches zero, you act as though you have stage 1 fatique or one stage lower if you are already fatigued. Normal hits will take away from your vitality first unless you choose to be hit (for whatever reason).


Wounds is where injuries start to be determined and actual hits come into play. Your total wounds is exactly equal to your constitution score. When a critical is scored against you, instead of multiplying the damage, the damage is directly applied to your wounds and bypasses your vitality. Even one point lost from your wounds means that you are injured.


Injury occurs when you lose at least 1 point of your wound score. The remaining wounds determines the severity of the injury. If you have already been injured, the previous injury stacks with the new injuries rather than being replaced by them. While an injury can be non-lethal, some can be and is similar to being at or below 0 hit points normally.

Location of Injury[edit]

First the location of the injury is determined by the value of the d20 rolled from the attack that has caused the damage. If the injury is caused by a critical failure, the d20 is rerolled for self-inflicted injuries (although critical fails are often used, they are not part of the core rules).

d20 Value Location
20 Head
19 Neck
18 Left Chest
17 Right Chest
16 Abdomen
15 Pelvis
14 Upper Back
13 Lower Back
12 Upper Left Leg
11 Upper Right Leg
10 Lower Left Leg
9 Lower Right Leg
8 Upper Left Arm
7 Upper Right Arm
6 Left Forearm
5 Right Forearm
4 Left Hand
3 Right Hand
2 Buttocks

Severity of Injury[edit]

There are five stages of severity for an injury: Grazed, Pained, Harmed, Disabled, Destroyed

Grazed is an injury that occurs if a victim loses one or more wounds. When grazed, the victim suffers a disadvantage for every roll associated with the part of the body that was injured for one round.

Pained is an injury that occurs if the victim has 3/4 or less of their wounds remaining. When pained, the victim suffers a disadvantage for every roll that would be associated with the part of the body that was injured for a number of rounds equal to the value of the highest damage die roll result. For example, if 2d6 was rolled for a great sword and one die read 4 and the other read 2, the harmed injury would last for 4 rounds.

Harmed is an injury that occurs if the victim has 1/2 or less of their wounds remaining. When harmed, a lasting injury has occurred that will leave a scar if allowed to heal naturally. The victim suffers a disadvantage for every roll that would be associated with that body part. The injury requires x amount of days to heal where x is equal to the highest damage die roll result. If the injury heals by natural means only, the injury is recorded permanently as a scar. If at any point in the future another harmed injury occurs three or more times, it becomes disabled regardless of remaining wounds.

Disabled is an injury that occurs if the victim has 1/4 or less of their wounds remaining. Disabling injuries are incredibly severe and may eventually cause death or at least unconsciousness due to the pain it causes and depending on the damage type. A disability will not heal naturally without assistance. If the body part that is injured is a vital part (20-13), the victim is dying and needs to be stabilized following the same rules as a character below 0 in the rulebook.

Destroyed is an injury that occurs if the victim has no wounds remaining. Destroyed means that the body part is completely destroyed. If it is a vital body part (20-13), this results in an instant death. If is an extremity (12-2), then the victim is dying and needs to be stabilized following the same rules as a character below 0 in the rulebook. Body parts can not be reattached or repaired without magical abilities that specifically state so. The damage type determines what state the body part is in.

Damage Type[edit]

Damage types determine the nature of an injury.

Severity Description
Grazed Scratched
Pained Cut
Harmed Flesh Wound
Disabled Bone Deep
Destroyed Severed
Grazed Poked
Pained Jabbed
Harmed Punctured
Disabled Stuck
Destroyed Impaled
Grazed Bumped
Pained Bashed
Harmed Bruised
Disabled Broken
Destroyed Pulverized
Grazed Singed
Pained Burned
Harmed Seared
Disabled Ignited
Destroyed Charcoal
Grazed Chilled
Pained Numbed
Harmed Frostbitten
Disabled Frozen
Destroyed Shattered
Grazed Sprayed
Pained Stung
Harmed Boiled
Disabled Corroded
Destroyed Dissolved
Grazed Pushed
Pained Impacted
Harmed Knocked
Disabled Blasted
Destroyed Obliterated
Grazed Sparked
Pained Zapped
Harmed Tased
Disabled Electrocuted
Destroyed Fried
Grazed Afflicted
Pained Diseased
Harmed Withered
Disabled Virulent
Destroyed Decomposed
Grazed Tainted
Pained Emetic
Harmed Contaminated
Disabled Nauseated
Destroyed Defiled
Grazed Throbbing
Pained Aching
Harmed Chronic
Disabled Comatose
Destroyed Brain Dead
Grazed sunburnt
Pained flashed
Harmed Smitten
Disabled microwaved
Destroyed Overcharged
Grazed Rumbled
Pained deafened
Harmed shattered
Disabled Concussed
Destroyed hemorrhaged

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