This article was first broadcast in Episode One Hundred Seventy Eight on 25 August 2021.
(Gnomish workshop door opens)
Lennon (in obnoxious good mood): Hi anyone here?
ROSTRO: Please state the nature of the mathematical inquiry.
Killer DM: Oh good! Lennon, maybe you can help with something.
Lennon (still in plastic good mood): Bye, I need to go dive in a gelatinous cube!
Killer DM: So when I said “maybe you can help” what I actually meant was “get your pasty bald self in here, you’re helping.”
Lennon: Look, my Charisma increased as a warlock, I still can’t help installing things in the machine.
ROSTRO: My physical chassis does not require any modification at this time. The Killer DM wishes to delve more into the subject of unconsciousness.
Lennon: Ohhhh I get to help with that? I’m pretty sure I still have enough of a strength score to swing a chair.
Killer DM: Mmmm, better be careful which chair you grab.
Lennon: Well I wasn’t going to use one of the nice ones.
ROSTRO: I believe the issue in question can be reviewed without the application of violence.
Lennon & Killer DM: Do we have to?
Killer DM: That never happened.
Lennon: What never happened?
Killer DM: Right. Laser light show, what have you got for us?
ROSTRO: If you consult the output crystals.
As previously reviewed, while there are numerous and varied ways to reduce characters in D&D to 0 hit points, actually killing them is an unlikely occurrence unless the Dungeon Master makes it a point to aim for that goal. This necessarily results in the frequent scenario of characters being left in a state of unconsciousness. For exhibit A, see Ostron.
In point of fact, the type of unconsciousness afflicting my creator is actually a-typical to the usual condition. As the process involves removing his astral being from his body, the body has gone into a sort of stasis, preventing aging and the need for food and air. The body could theoretically be deposited in a basin of non-toxic, non-corrosive liquid and still remain functional even if left for a length of time that would ordinarily be problematic.
Anyway, let’s review the basics. When I drop characters to 0 HP, because you know that’s going to happen as often as possible, they immediately fall unconscious. To start with the obvious stuff, that means they drop whatever they’re holding, fall prone, and lose the ability to move or speak. However, everyone with the mind-melting magic and poison needs to calm themselves because those are actually the only saves affected by the status. Apparently blood loss means you can’t lift anything or get out of the way of an advancing slug but you can still recite multiplication tables in a pinch.
Lennon: I’ve seen him do it, it’s not pretty.
Killer DM: Okay, I just had the same thought as you at the same time again and that needs to stop. I’m blaming you.
Anyway, it should again be obvious but unconsciousness means incapacitation, which means no actions or reactions. The reason incapacitated is called out, rather than adding it to the list of things along with not moving or speaking, is that incapacitation refers to the separate condition that means any concentration spells stop. This is why you always incapacitate the bard first.
The other thing unconsciousness does is automatically grants advantage to all attack rolls against that creature. That means even if you’re a ranged character you’ve got a decent chance of hitting an unconscious creature because the disadvantage from them being prone is cancelled out by the automatic advantage. Even still it’s worth running in close because any attack that hits where the attacker is within 5 feet is an automatic critical.
Now, why would automatic criticals matter; after all if something is unconscious it’s already at 0 hp, right? Well to start with there are a few things other than damage that cause the condition. The “sleep” spell is one of the more obvious ones, but also any magical construct subjected to an antimagic field that fails its save is considered unconscious in terms of the rules. Both are cases where you’ve got an unconscious creature who will still retain a good portion of their hit points.
However, given that the overview began from the perspective of player characters being unconscious, information shall focus on that scenario for the time being. While it is considered a sign of a particularly malicious Dungeon Master, the potential damage that could be inflicted from an attack on an unconscious character means it is tactically imperative to remove the character from potential harm. Automatic criticals would theoretically double the damage taken by the character, and the threshold of death being immediate if a character suffers damage in excess of zero that equals their hit point total becomes much more likely when the character is beginning from zero.
The subject of death saving throws has been reviewed previously and shall not be dissected again at this point, except to note that the situation where a character succeeds on three saving throws or is otherwise stabilized through the use of a medicine check or a “Spare the Dying” spell merely eliminates the need for further saves. The character remains unconscious as long as their total health continues to be 0.
So even though most people use healing spells to fix the problem, it’s worth keeping in mind getting a character back on their feet after I’ve given them a love tap is technically a two step process; first they’re stabilized but unconscious, then they need healing to become conscious again. Giving them any amount of healing solves both problems, but if the cleric’s tapped out, you used your last healer’s kit to stabilize your buddy, the barbarian drank all your healing potions while dancing the mamba with the purple worm, and the only other character with healing spells is the one on the ground, it means you either have to make sure the entire area can be made safe for an hour (and I’m not letting you do that, obviously) or somebody has some extra weight to carry.
None of this applies to people that are asleep by the way. While a sleeping person is unconscious, they aren’t there as a result of being at 0 HP so it’s a lot easier to get them up and about. I usually use a dagger. That said, there is a bit of a devil’s choice if things are going sideways while someone’s having a lie down. It’s difficult to find rules that specifically relate to sleeping creatures outside of the spell “sleep,” but that spell does say that if you want to wake up a creature in a way that doesn’t do damage, it requires an Action. So you have to figure out if your action is better spent making attacks against the charging gnolls or waking up the bard. And really, what is Rosanne the Raucous going to do anyway, break a banjo string at them?
In short, whether they’re dying or not, it’s a good idea to make sure characters who are unconscious get that fixed sooner rather than later because things will be a lot better for them if it is.
Moving on from the nerve-wracking scenario of a player character sitting at 0hp, it is also possible for NPCs to be rendered unconscious. There is of course the scene of the rogue sneaking into a barracks or a bard stealthing into a bedchamber…really?
Comparative review of anecdotes suggests the bard’s activities are at least the second most common occurrence of a player character encountering a sleeping non-player creature.
Okay, theres…a lot to unpack there.
Anyway, sleeping NPCs are in the same situation as sleeping player characters, in that they’re unconscious. However, there is a point in the rules that has caused a few debates around some tables.
The rules for the unconscious status specify that the creature is “unaware of their surroundings.” This has caused a number of measured and perfectly reasonable discussions about whether that meant characters could not bother with stealth sneaking through that sleeping barracks or, conversely, if a spell that required characters to hear them would work if they were asleep, since they’re totally unaware per the rules.
When Xanathar’s Guide to Everything came out it expanded upon this a little bit by granting that sudden loud noises can wake sleepers, and that a character with a passive perception of 20 would be woken by loud whispers if they were within 10 feet, but unfortunately that leaves a huge amount of leeway for interpretation.
For all practical purposes the determination of what activities will or will not wake sleeping individuals is the purview of the Dungeon Master. They will dictate the parameters of the encounter and if there is disagreement the player will be summarily stripped, beaten, and chased around the exterior of the building by rabid hedgehogs.
Lennon: I’m sorry, what?
ROSTRO: I was informed this is the new paradigm for encouraging player cooperation at the gaming table.
Killer DM: What?
The situation of an unconscious non-player character whose HP total has reached 0 is an unusual one. By default it is assumed that any antagonistic creature reduced to 0HP in combat is rendered inanimate. A partial explanation for this is to reduce bookkeeping responsibilities assigned to the Dungeon Master, and additionally reducing complications for players. The alternative is to have the Dungeon Master making and tracking death saves for a number of creatures each combat encounter and then presenting the players with the possibility of unconscious rather than dispatched enemies at the end of an encounter, with the subsequent moral dilemma of how to approach that reality.
If you want to run a game like that because you think making your players wrestle with the reality that they’re mass murderers every fight is fun or makes the game have deeper meaning or whatever, go enjoy yourself but there’s no way in the nine hells you’re getting me to do that kind of paperwork. However, there’s always time for torture!
If players want to keep an enemy alive after a battle so they can string them up and bleed them slowly while asking questions about swallows and favorite colors, there are rules for that! Well, rules for the unconscious bit, for some reason they didn’t see the need to design rules around how to torture people for information.
Anyway, the rules state that if a creature is reduced to 0 HP by a melee attack, the attacker can opt to knock them unconscious rather than kill them. Now, again there’s a lot of grey area. If someone walks up with a mundane sword, it’s easy enough to assume they used the flat of the blade or the little knob on the end rather than the pointy bit. However, when a paladin charges forward on a horse and scores a critical hit with a mace that’s also been supercharged with the glowing power of the paladin’s massive ego, I question how exactly that results in someone being unconscious as opposed to their head being driven like a golf ball. Same thing with a cleric manifesting the literal essence of death and slapping someone upside the head. But that’s what the rules say, so unless you want to make non-lethal attacks something that’s really hard for the characters to manage, that’s the way it works.
Another unfortunate omission from a storytelling point of view is the “knock the guard out in the hallway” scenario. By the letter of the rules, the only way to knock a creature unconscious is to drop them to 0HP. For any creature over CR 1 or so, that’s going to be difficult for any character to do in 1 hit. Rogues are actually slightly better at it, because that makes sense, but even still at level 4 a rogue with a rapier and sneak attack is averaging 16 damage a hit without a nat 20. A CR 3 archer patrolling around has 75 hit points. You’d probably need the entire party to pile on the damage to drop them to 0, and that’s well out of the range of the sleep spell’s basic power as well.
Again, if the characters or the DM are counting on someone quietly sneaking through and knocking out guards in a single hit along the way, you either have to come up with custom rules for it or the DM has to put a lot of low-CR creatures on guard duty.
In the event that a creature is rendered unconscious through non-magical means and remains stable at a zero hit point value, adjudication is relatively straightforward. The Player’s Handbook for 5th edition states such a creature will regain 1 hit point after 1d4 hours of in-game time. Therefore while recreating the scenario of a simple stealthy attack rendering a guard unconscious is somewhat difficult to achieve with 5th edition’s game mechanics, those same mechanics do readily support the state of affairs wherein a creature is deposited in a storage room and assumed to be a non-factor in continuing operations.
In such situations, however, it behooves participants to recall that any amount of damage sustained by the unconscious creature will immediately destabilize their condition and require further death saves. Also recall death saves are cumulative between long rests. If the creature failed two saves prior to stabilization and was then injured requiring another immediate save, they are in the unenviable position of facing permanent death after failing a single saving throw. Also recall that a non-stable character taking any damage immediately fails two death saves. Combined with the aforementioned accumulation of failures, it is recommended that any characters assigned the task of transporting an unconscious individual ensure they are both capable of transporting said body without difficulty and that the path of traversal is relatively clear of obstacles.
Yes, carrying the unconscious person over one’s shoulder and killing them because you took a corner too fast isn’t a good look. Still hilarious, but not a good look.
I think we can wrap this up with a reminder for the DMs out there; you are effectively the god of death in your games as you are the god of everything else, so of course feel free to tweak these rules when and however you wish. For example the game doesn’t really have a mechanic for choke holds either and I know that’s another way action heroes like to make people take an involuntary nap. However, if you want more unconsciousness in your game there’s probably going to be extra work involved for you. Or you can just have Ostron run it.
Lennon: Why did you want to look into unconsciousness anyway?
Killer DM: Well I mean kidneys are apparently even better if you get them from a live donor, and I hear Gath has been getting uppity about all the resurrections and healings you all force him to do, so I wanted to know if nephilimectomy could be done when he’s like this.
ROSTRO: I believe the correct term is nephrectomy.
Lennon: I believe the correct term is NO! You are not taking Ostron’s kidneys every time ROSTRO turns on! And he’d still be dead at the end!
Killer DM: I’d only take one of them, then I just grab the other the next time he dies. That cuts down on the resurrection! It’s really for Gath’s benefit, you know.
ROSTRO: It would represent a more stable availability curve for the organs in question.
Lennon: There is nothing stable about this! Look, I’m going over to the scrying pool. If Ostron’s not over there in two minutes I’m sending RaeRae in to check on him. Good luck to you if she finds you elbow deep in Ostron’s stomach.
Killer DM: Again, ruining my fun.