Healing, Death, and Dying

Damage reduces your hit points.

✦ Maximum Hit Points: Your class, level, and Constitution score determine your maximum hit points. Your current hit points can’t exceed this number.

✦ Bloodied Value: You are bloodied when your current hit points drop to your bloodied value or lower. Your bloodied value is one-half your maximum hit points (rounded down). Certain powers and effects work only against a bloodied enemy or work better.

✦ Dying: When your current hit points drop to 0 or lower, you fall unconscious and are dying.

Most healing requires you to spend a healing surge. When you spend a healing surge, you restore lost hit points to your current hit point total. Once per encounter, you can use your second wind to spend a healing surge and heal yourself. After a short rest, you can spend as many healing surges as you like outside combat. You can spend a limited number of healing surges per day. When you take an extended rest, your number of healing surges is replenished.

Some powers (either your own or those of another character) allow you to heal as if you had spent a healing surge. When you receive such healing, you don’t actually spend a healing surge.

✦ Number of Healing Surges: Your class and Constitution modifier determine how many healing surges you can use in a day.

✦ Healing Surge Value: When you spend a healing surge, you regain one-quarter of your maximum hit points (rounded down). This number is called your healing surge value. You use it often, so note it on your character sheet.

✦ Monsters and NPCs: As a general rule, monsters and nonplayer characters have a number of healing surges based on their tier: one healing surge at the heroic tier (1st–10th levels), two healing surges at the paragon tier (11th–20th levels), and three healing
surges at the epic tier (21st–30th levels).

Even in a heated battle, you can heal. You can heal yourself by using your second wind, an
ally can use the Heal skill on you, and an ally can use a healing power on you. When a power heals you, you don’t have to take an action to spend a healing surge. Even if you’re unconscious, the power uses your healing surge and restores hit points. And some healing powers restore hit points without requiring you to spend a healing surge.

Regeneration is a special form of healing that restores a fixed number of hit points every round. Regeneration doesn’t rely on healing surges.

REGENERATION
✦ Heal Each Turn: If you have regeneration and at least 1 hit point, you regain a specified number of hit points at the start of your turn. If your current hit point total is 0 or lower, you do not regain hit points through regeneration.

✦ Limited by Maximum Hit Points: Like most forms of healing, regeneration can’t cause your current hit points to exceed your maximum hit points.

✦ Not Cumulative: If you gain regeneration from more than one source, only the largest amount of regeneration applies.

A variety of sources can grant you temporary hit points—small reservoirs of stamina that insulate you from losing actual hit points.

TEMPORARY HIT POINTS
✦ Not Real Hit Points: Temporary hit points aren’t real hit points. They’re a layer of insulation that attacks have to get through before they start doing damage to you. Don’t add temporary hit points to your current hit points (if your current hit points are 0, you
still have 0 when you receive temporary hit points). Keep track of them as a separate pool of hit points.

✦ Don’t Count toward Maximum: Temporary hit points don’t count when you compare your current hit points to your maximum hit points, when you determine whether you’re bloodied, or for other effects that depend on your current hit points.

✦ Lose Temporary Hit Points First: When you take damage, subtract it from your temporary hit points. If you take more damage than your temporary hit points, extra damage reduces your current hit points.

✦ Don’t Add Together: If you get temporary hit points from different sources, use the higher value as your temporary hit point total instead of adding the values together.

✦ Last until You Rest: Your temporary hit points last until they’re reduced to 0 by damage or until you take a rest.

✦ Dying: When your hit points drop to 0 or fewer, you fall unconscious and are dying. Any additional damage you take continues to reduce your current hit point total until your character dies.

✦ Death Saving Throw: When you are dying, you need to make a saving throw at the end of your turn each round. The result of your saving throw determines how close you are to death.
Lower than 10: You slip one step closer to death. If you get this result three times before you take a rest, you die.
10–19: No change.
20 or higher: Spend a healing surge. When you do so, you are considered to have 0 hit points, and then your healing surge restores hit points as normal. You are no longer dying, and you are conscious but still prone. If you roll 20 or higher but have no healing surges left expressed as a negative number, your condition doesn’t change.

✦ Death: When you take damage that reduces your current hit points to your bloodied value expressed as a negative number, your character dies.

Example: Anvil, a dwarf fighter, has a maximum hit point total of 53. He’s bloodied at 26 hit points, dying at 0 hit points, and dead at –26 hit points. In a fight with an umber hulk, Anvil is reduced to 18 hit points. The monster later hits him for 33 points of damage. This reduces Anvil’s current hit points to –15. He’s now unconscious, dying, and only 11 points of
damage away from death.
Monsters and characters controlled by the Dungeon Master usually die when they reach 0 hit points, unless you choose to knock them out (see “Knocking Creatures Unconscious”). You generally don’t need to stalk around the battlefield after a fight, making sure
all your foes are dead. Death is not necessarily the end in the DUNGEONS & DRAGONS game! Some powers and the Raise Dead ritual can return a dead character to life.

Most monsters don’t attack combatants who are dying; they focus on any characters still on their feet and posing a threat. But some particularly wicked monsters might attack a dying character on purpose (even using a coup de grace), and monsters make no effort to avoid including a dying character in an area attack or a close attack aimed at other characters who are still fighting.

When you reduce a creature to 0 hit points or fewer, you can choose to knock it unconscious rather than kill it. Until it regains hit points, the creature is unconscious but not dying. Any healing makes the creature conscious. If the creature doesn’t receive any healing, it is restored to 1 hit point and becomes conscious after a short rest.

When you are dying, any healing restores you to at least 1 hit point. If someone has stabilized you using the Heal skill but you receive no healing, you regain hit points after an extended rest.

HEALING A DYING CHARACTER
✦ Regain Hit Points: When you are dying and receive healing, you go to 0 hit points and then regain hit points from the healing effect. If the healing effect requires you to spend a healing surge but you have none left, you are restored to 1 hit point.

✦ Become Conscious: As soon as you have a current hit point total that’s higher than 0, you become conscious and are no longer dying. (You are still prone until you take an action to stand up.)
Example: Anvil is at –15 hit points. His companion Terov, a cleric, uses healing word to help him. This assistance immediately raises Anvil’s current hit points to 0 and allows him to spend a healing surge boosted by Terov’s extra healing from healing word and the Healer’s Lore class feature. The healing surge (13 hit points) plus Terov’s boost (6 hit points) restores Anvil to consciousness and increases his current hit point total to 19.