However, I can see how some DMs may want you to keep rolling until another PC actually makes a heal check or uses magic to revive you. This could be especially important if there is another encounter just around the corner.

Thank you; your post was perfect, it answers all my questions. I never knew about the rule “you start counting from zero no matter what your negative score is.” That really changes how I read the whole death and dying section.

Thanks again this place rocks!

Thanks for posting again. We’re always glad to hear from our readers. Let me see if I can answer your questions. I’ve talked with Wimwik and here’s how we interpret this situation.

For purposes of this example lets assume your character has 40 hit points.

Scenario 1
If you take enough damage to reduce you to -21 hit point or less then your character is dead. Period. He’s fallen below his bloodied value expressed as a negative number. No save. He’s dead.

Scenario 2
If you take enough damage to reduce you to anywhere between 0 and -20 hit points your character isn’t dead yet. But he is dying. He needs to make a death saving throw each round on his turn until he recovers or dies. He won’t loose any additional hit points unless he’s attacked or has ongoing damage. Your save is not affected in any way by your current hit points.

What happens next will depend on what you roll and whether or not anyone comes to your aid.

See page 295 PHB > Death and Dying > Death Saving Throw

• 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.

In other words…

• Every time you roll 1-10 you get 1 strike. If you accumulate 3 strikes you’re dead. Stop rolling saving throws and roll up a new character.
• If you roll between 11-19 then nothing changes. You don’t get any better and you don’t get any worse (unless you’re attacked or have ongoing damage).
• If you roll a 20 then you’re back in the game. You get to spend a healing surge and are no longer unconscious.

Remember that in 4e D&D any time you’re below 0 hit points and you receive healing, no matter the source, you always start counting from 0. So if the abovementioned character has -17 hit points and rols a 20 on his death saving throw he gets to spend a healing surge. His surge value is 10 hit pints (1/4 of his 40 maximum). So he’d wake up and have 10 hit points (since he started counting from 0). The fact that he was at -17 doesn’t matter.

There are powers, feats and items that provide modifiers on saving throws (like the Human Perseverance feat). This is added to the d20 roll. That is why the Death Saving Throw chart says 20 or higher.

Read the Heal skill on page 185 of the PHB. A PC can help an ally by using First Aid as a Standard action.

• A DC 10 Heal check allows an adjacent character to use his or her second wind without the character having to spend an action.
• If the dying character has already used his second wind then a DC 15 Heal check allows an adjacent ally to immediately make a saving throw.
• If you’ve already got 2 strikes and don’t want to risk death by failing another roll, a DC 15 Heal check can stabilize an adjacent dying character. If you succeed, the character can stop making death saving throws until he or she takes damage.

I know this is a lot to take in, but I hope this helped. Post again if you have more questions. Or feel free to email us. Our contact information is on the About page.

I’m new to D&D and I don’t fully understand dying, I’d like to clarify a few things if possible. My general understanding is that once below zero there are two ways to die: Fail 3 saving throws, or your HP is reduced to your negative bloody score.

My questions are:
If you take so much damage that you are reduced to a negative bloody state from an above zero HP value, do you instantly die without a death saving throw opportunity?

When you fail a death saving throw do you loose any more HP, or if you loose more HP does it affect the saving throws in anyway? (Are they related in anyway?)

This part of the PH really bugs me (quote): ’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.’

(Quote question #1)
If you are reduced to exactly zero HP and you roll a 20 on your saving throw, and spend a healing surge do you just remain at zero (this is technically how it’s written, but seems odd considering rolling 10-19 means no change)?

(Quote question #2)
The part where it says ‘…then your healing surge restores hit points as normal.’ What do they mean: The same healing surge just spent then restores you as normal? (I feel that wouldn’t make sense, but the wording implies it’s the same healing surge.)

Assuming the answer to quote question #2 is something like, “No it’s not the same healing surge; they mean the next healing surge you use on your next turn”: Do you have to do yet another saving throw on that “next turn” before you are allowed it use the “next healing surge?” (I feel this is odd too, but technically you are still categorized as ‘Dying’)

Yep, I’ve definitely over complicated this, but I’d rather just know exactly how it works.
Any help would be appreciated.