Lazlo COS Pathfinder - Low Magic
Death, Damage and Healing
NOTE: The use of the Healing skill is heavily integrated into this section.
Natural Healing: under the D20 RAW natural healing is simply too good and allows characters with nearly severed limbs to bounce back to full health after 2 or 3 days of rest. This is not the case under the LCM Ruleset. Characters recover their Con Bonus, or 1/3 their level (whichever is greater) to a minimum of 1 HP per day.
This means that a “master” level character at 10th level would recover 3 HP/day unless he has a very high Con bonus. Natural healing will not heal damage from Critical Hits or a failed Massive Damage check and without divine healing magic, or a medic to perform surgery, such a character can expect massive injuries to remain and a permanent reduction in HP, possible stat damage, permanent limb damage, etc.
If a character is injured below 0 HP but is stable (no bleed effects), natural healing will mend their wounds at a rate of 1 HP/day until their HP raises to a positive number, at which point normal healing begins.
Treatment for Serious Injuries, Critical Hits and Massive Damage
A character who has taken damage equal to their MDT has suffered a Serious Injury, and will lose one Hit Point every round (or every minute if out of combat) until they recieve a minimal of Frist Aid care.
Heal Check (First Aid): Skill check against the targets MDT. The attempt takes a full-round action; several tries can be made until successful. If the character is trying to dress his or her own wounds, apply a – 5 penalty. If successful the Heal check reduces bleeding from once per round, to once per minute if they are still in combat, or once per hour outside of combat. Multiple bleed effects are cumulative. Example: three bleed effects totaling 4 hp per round, could be reduced to 4 per minute or 4 per hour depending on combat.
Triage (First Aid) A medic may make a Heal check (DC 15) as a standard action to determine the condition of a single creature. With a successful check, a medic may automatically determine whether a creature is dead, dying, poisoned, diseased, knocked out, etc and thus triage who is in the most immediate need of their skills.
Surgery (Serious Injury / Treat Deadly Wounds)
Prerequisite: Heal Skill bonus of + 10
Treat Deadly Wounds completely stops bleed effects with a Heal Check DC of the MDT + the amount of HP they are losing from bleed effects. Otherwise the skill functions per RAW. (REFERENCE)
There is no penalty to this check if performed in a clean, dry location with suitable equipment available, but a -4 penalty applies if it is performed with less adequate facilities (for example, using incomplete or low-quality tools or an inappropriate location) or -8 if performed with completely improvised equipment(for example, on the ground near in a dirty battlefield using only what can be found nearby).
Stopping a serious bleed effect takes 1 minute per point of blood loss / min, blood loss is suspended during the attempt. Success = no additional loss, the treatment was successful. Failure = blood loss resumes normally at the end of the Healing attempt. Fumble = suspended damage is applied all at once and the bleeding resumes. Critical success would completely stop the blood loss and allow for + 2 additional HP recovered per day of full rest (with treatment) due to how well the initial surgery had gone.
Long Term Care: During long term care allows the Medic to make a Heal check once per day with a DC of the MDT (minimum 15). Success equals an additional + 1 hp/day per 5pts by which the check succeeds. Otherwise the skill is as per RAW.
Ability Damage heals at the rate of 1 pt per 10 days minus the Con bonus of the victim (16 Con would allow 1 point of ability recovery every 7 days). With full bed rest the recovery rate is increased to 1 pt per 5 days minus the Con bonus (at 16 Con would be 1 point every other day). Full bed rest and the care of a competent medic who makes his Heal checks every day would be 1 pt / 3 days minus Con bonus (with a 16 Con this would increase to 2 point per days!)
Healing of Conditions or Effects such as Blindness, Disease, and most effects that damage ability scores (such as a wraith attack or poisons) etc are based upon an opposed roll against the original Save which created the affliction. Once the onset has had time to set in however many of these effects will be permanent, or require a specific item as a material component which can only be obtained as a quest reward to overcome.
The exact timing for how long before the effects "set in" are ultimately up to the DM, however the question to consider when making such a ruling would be, "Is this supposed to be part of an encounter or a set up for a larger plot line device"?
Effects of Disease - are applied once per hour, a successful Heal Check which beats the DC by + 10 slows progression of the disease to once per day. Long Term care with full bed rest also reduces progression to once per day and may attempt to cure the disease once per 3 days with a successful Heal Check vs the DC of the Disease. Recovery of damage does not begin until the condition is cured.
Effects of Poison - are applied every 3 rounds, a successful Heal check slows the poison progression to once per hour assuming the patient is resting. Long Term care may attempt to cure the poison once per hour with a successful Heal Check vs the DC of the poison. Recovery of damage does not begin until the poison is fully neutralized.
Bleeding out at zero HP = At zero HP the character is unconscious and Bleeding Out (1hp/minute) until they reach their negative Con score. (NOTE: “unconscious” can also be interpreted as “too messed up to do anything” but still give a cool death speech, “Luke…I am your father…”)
Back from the Brink: Once you are past the negative Con score you are dead. At which point you still continue to lose 1 hp per minute. During this phase only magical healing can bring you back by healing enough damage to raise you to at least your negative Con score with a single spell or channeling attempt. If you receive such healing your condition is truly stable and you take no further loss of HP from blood loss and may begin natural healing. Example: 12 minutes ago you fell below your negative Con score and are now dead. If you receive at least 13 points of divine healing that will bring you back to one point above your negative Con, thus restoring you to life (althought still unconscious and in a world of hurt).
Put Pressure on the Wound: A character who does not have the required skill in healing may still assist a character who is bleeding out by apply a full round action to Put Pressure on the Wound and slow the bleed effect. This attempt is made at a + 10 heal check, but the effect ends as soon as the would be medic stops rendering aid. Attempting to Put Pressure on the Wound for your own injury incurrs no penalty, but the character is limited of only making a 1/2 movement per round.
Magical healing on Bleed Effects: Spells that restore HP, such as the Cure X Wounds line, stop 1hp/rd per dice of the spell used, for example if the victim is suffering 3hp/rd from bleed effects it would require a 3d6 cure spell (or greater) to completely heal its bleed effect, or 3 spells at 1d6 used over several rounds to finally control the blood loss. If the caster also has the Good Domain they may add their Wisdom bonus to the number of Hp/Rd stopped per spell. The Healing Domain increases the effectiveness of the dice by 50%, IE; 4d6 heals 4 bleed hp/rd but with the Healing Domain it becomes 6 bleed hp/rd. This type of healing also recovers HP normally while addressing the issue of blood loss, it is not a one or the other approach.
NOTE: This is different from Back from the Brink above which is intended as a last ditch effort.
Un-Assisted Characters: A character who is unconscious and Bleeding Out without assistance is normally doomed to a slow and painful death at the rate of 1hp / minute. If a PC has a Freebie point they may use it to stablize their condition and begin natural healing, or use a Freebie point to allow them to be found by companions on a littered battle field, etc.
Healing Magic and Raising the Dead It is generally assumed that healing magic (and Surgery) are being used at the time of the injury to avoid long term effects. If a serious condition is allowed to heal on its own a person’s life may be spared, but permanent maiming and ability damage (such as the loss of a limb) would still remain. Additional limitations may also be appropriate such as reduced movement rates, ranged attack penalties (in the case of a lost eye), etc. For such permanent injuries stat damage and reduced max HP would be expected (unassisted natural healing can't heal wounds from Critical hits).
Raise Dead, Regeneration, Restoration, and similar magics are completely BANNED under the LCM Ruleset. Once the character has died they are gone (see Back from the Brink above). Death is both serious and permanent.