Any combatant that reaches 0 hit points is incapacitated and unable to act. They begin to bleed out bleeding out.

There are thirteen damage types

This group represents damage done by weapons and mundane venom

• Slashing
• Piercing
• Bludgeoning
• Poison

This group represents the elemental damage done by earth, air, fire, and water

• Acid
• Lightning
• Fire
• Cold

This group represents the two poles of angelic and demonic damage

• Radiant
• Necrotic

This final group represents magical energies

• Thunder
• Force
• Psychic

Certain monsters or characters may have abilities which make them resistant to fire damage or vulnerable to acid damage, for example. Each of these essentially acts as a modifier to the total damage taken by that specific type of damage. If multiple types of damage are done, the damage modifier is only applied to the relevant damage rather than the total.

Resistance: The target takes half damage

Vulnerability: The target takes double damage

Immunity: The target takes zero damage

Whenever you reach 0 hit points, you enter the death countdown. You tick off one box on the character sheet for each round that passes, and when you have reached -10 points, you have bled out and are now dead. To avoid bleeding out, you must be stabilized by another's action.

• Stabilizing a Creature: 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 bleeding out. You can use your action to administer first aid to an unconscious creature and attempt to stabilize it, which requires a successful Medicine check. Once a creature is stable it has no further danger of death by bleeding out, even though it has 0 hit points, but it does remain unconscious and must roll on the Injury Table below. The creature stops being stable, and must start making death checks again, if it takes any damage. A stable creature that isn't healed regains 1 hit point after 1d4 hours and becomes conscious once again.

• Monsters and Death: Most GMs have monsters and NPCs die the instant it drops to 0 hit points, rather than having it fall unconscious and make death checks. Mighty villains and special NPCs are common exceptions. The GM might have them fall unconscious and follow the same rules as player characters.

See also Healing and Injury for stabilization and recovery rules.

Once a character is stabilized, roll on this table to determine any lasting wounds were inflicted by the blows that knocked them to zero hit points. These effects last until they are mitigated using the rules found in the recovery rules.