Negative Hit Points (5e Variant Rule)

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Negative Hit Points[edit]

The following sections under "Dropping to 0 Hit Points" on pg. 197 of the PHB have their text changed to the following:

Instant Death[edit]

Massive damage can kill you instantly. When damage reduces you to 0 hit points and there is damage remaining, you gain a number of special points called negative hit points equal to the remaining damage. Negative hit points are not considered to be hit points. Negative hit points persist between turns, and there is no limit on how many of them you can have at once. If your total number of negative hit points equals or exceeds your hit point maximum, you die.

For example, a cleric with a maximum of 12 hit points currently has 6 hit points. If she takes 14 damage from an attack, she is reduced to 0 hit points, but 8 damage remains. The remaining damage is converted into 8 negative hit points, which are kept between turns. Her unconscious form is hit by a second attack that deals 4 damage. The cleric suffers her failed death saving throws, but also gains another 4 negative hit points. She now has 12 negative hit points, which equals her hit point maximum, so the cleric dies.

Death Saving Throws[edit]

Rolling 1 or 20. When you make a death saving throw and roll a 1 on the d20, it counts as two failures. If you roll a 20 on the d20, you lose all negative hit points and regain 1 hit point.
Damage at 0 Hit Points. If you take any damage while at 0 hit points, you gain that many negative hit points. In addition, you suffer a death saving throw failure. If the damage is from a critical hit, you suffer two failures instead.

Stabilizing a Creature[edit]

The best way to save a creature with 0 hit points is to heal it. If healing is unavailable, the creature can at least be stabilized so that it isn't killed by a failed death saving throw or negative hit points. If a creature with negative hit points were to regain hit points, the amount of healing instead reduces the creature's negative hit points. If the healing reduces a creature's negative hit points to 0 and there is healing remaining, the remaining healing is applied to the creature's hit points.

You can use your action to administer first aid to an unconscious creature and attempt to stabilize it, which requires a successful DC 10 Wisdom (Medicine) check.
A stable creature doesn't make death saving throws, even though it has 0 hit points, but it does remain unconscious. The creature stops being stable, and must start making death saving throws again, if it takes any damage. A stable creature has its negative hit points reduced by half when it becomes stabilized, and if it isn't healed to at least 1 hit point it loses all negative hit points and regains 1 hit point after 1d4 hours.

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