Alternative Conditions (4e Variant Rule)
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To better simulate certain effects in a game and further immerse a player in the world and its danger, conditions not limited to battle are used. For example, the use of drugs may make one drunk. There are also conditions here which reflect game mechanics from videogame RPGs, which may be positive rather than negative. This makes them an addition to existing conditions but also replaces the solely negative definition as given in the 4th edition.
The creature's speed becomes 3 if it was higher than that. They also take a -2 penalty to attack rolls and Reflex saves. However, they also become harder to hit, granting combat disadvantage. This means that you roll two dice and take the lower result instead.
The creature that is high takes a -2 penalty to Will saves but gains a +2 to saves against powers and effects with the charm and fear keywords. After finishing a short rest, high characters are no longer high.
You grant combat advantage to attacks dealing lightning damage. You also have a -2 to saves against lightning damage.
A fatigued character cannot run, shift, or charge. They take a -2 penalty to their Strength and Dexterity scores. Doing anything that would normally cause fatigue causes the fatigued character to become Exhausted. After an extended rest, fatigued characters are no longer fatigued.
An exhausted character moves at half speed and takes a –6 penalty to their Strength and Dexterity scores. After a short rest, an exhausted character becomes Fatigued instead. A fatigued character becomes exhausted by doing something else that would normally cause fatigue.
This is an alternative rule to treating suffocation in modified survival rules.
A PC that requires breath can typically hold their breath for one minute under normal circumstances. At the end of one minute without breathing or without enough air in an area to breathe, they become Fatigued. After another minute without breathing, they also become weakened in addition to being fatigued. After a third minute, they also become dazed. After the fourth minute, they become unconscious. After the fifth minute, the PC is dying. On their next turn, if they still cannot breathe, they instantly die.