Critical Injuries

All creatures have a Critical Injury Threshold equal to their Constitution Score plus their Level.

A creature recieves a critical injury when:

It takes damage equal to or greater than its Critical Injury Threshold from a Critical Hit (after resistances).
It rolls a 1 or lower on a Saving Throw against an effect that deals damage.
It takes fall damage equal to or greater than its Critical Injury Threshold (after resistances).
It takes double its Critical Injury Threshold in damage from a single source (after resistances).

Physical Critical Injuries

When a creature recieves a Critical Injury from physical damage (Bludgeoning, Piercing, or Slashing), roll on the table to determine the injury they receive.

Fall damage typically prioritizes breaking legs first, but the critical injury recieved from falling can vary depending on how the creature lands.

Roll (1d8)	Injury	Injury Effect	Quick Fix (Medicine Check)	Treatment (Surgeon's Tools)
1	Collapsed Lung	-10 to move speed (minumum 5 feet). -2 to Death Saving Throws.	DC 17	DC 15
2	Broken Ribs	Suffer 1d8 damage every time you move more than 5 feet on your turn.	DC 15	DC 15 DC 20 (Medicine)
3	Broken Arm	Roll 1d2 to determine limb (1 = left, 2 = right). The arm cannot be used and all items held in the hand are dropped.	DC 15	DC 15 DC 20 (Medicine)
4	Foreign Object	Suffer 1d8 (per foriegn object) damage every time you move more than 5 feet on your turn.	DC 15	Quick Fix Removes Injury
5	Broken Leg	Roll 1d2 to determine limb (1 = left, 2 = right). -20 move speed (minimum 5 feet), DC 16 Athletics or Acrobatics check to stay standing.	DC 15	DC 15 DC 20 (Medicine)
6	Torn Muscle	Roll 1d4 to determine limb (1 = left leg, 2 = right leg, 3 = left arm, 4 = right arm). -5 move speed per torn leg muscle, disadvantage on Dexterity Saving Throws. -2 to d20 rolls made using a arm with a torn muscle.	DC 15	Quick Fix Removes Injury
7	Spinal Injury	Target gains the Incapacitated condition until the end of their next turn. -2 to Death Saving Throws.	DC 17	DC 15
8	Crushed Fingers	-4 to all checks involving that hand.	DC 15	DC 15

Magical Critical Injuries

Magic damage can also cause critical injuries; however, their injuries are mostly set.

Damage Type(s)	Injury	Injury Effect	Removal
Fire, Radiant, Black Fire	Singed	-2 to all d20 rolls.	Quick Fix (DC 15 Medicine)
Cold	Frostbite	Halved move speed.	Quick Fix (DC 15 Medicine)
Lightning/Ancient Dragon Lightning	Shocked	Cannot take reactions for two turns. Creatures that recieve this critical injury again before it clears gain the Stunned condition until the end of their next turn (removing Shocked)	Clears after 2 of the affected creature's turns
Poison	Poisoned	Creature gains the Poisoned condition (unless it is immune).	Quick Fix (DC 15 Medicine)
Acid	Melted	AC is reduced by 2 This effect does not cause a penalty to Death Saving Throws.	Permanent on non-magical armor (DC 15 Smith's Tools check over 1 minute to clear or Mending Cantrip) This effect otherwise clears after 2 of the affected creature's turns.
Thunder	Tinnitus	Whenever you move more than 10 feet in a turn, you cannot move on your next turn. Additionally, you have a -2 to Perception Checks involving hearing.	Quick Fix (DC 15 Medicine)
Scarlet Rot	Scarlet Rot	Creature gains the Scarlet Rot condition (unless it is immune)	Clears after 1 minute
Necrotic	Necrosis	Creatures take an additional die of Necrotic damage when struck with Necrotic damage. This can stack.	Quick Fix (DC 15 Medicine)
Force	Impacted	Large or smaller creatures are pushed back 5 feet. Disadvantage on all attack rolls until the end of next turn	Clears after 1 of the affected creature's turns
Psychic	Befuddled	-2 to all d20 rolls. Must move 10 feet in a random direction at the start of turn.	Clears after 2 of the affected creature's turns

Death Saving Throws

Penalties to Death Saving Throws subtract from what you roll. This does not count Nat 20s, which restore you to 1 hp.
A creature suffering from a critical injury has a -1 to Death Saving Throws for each critical injury they are suffering (added to any penalties from Collapsed Lung or Spinal Injury).
If a creature rolls a natural 1 or rolls less than 1 on a Death Saving Throw, they recieve 2 failed Death Saving Throws.
Critical injuries that stack (Foriegn Object, Necrosis, Tinnitus) only provide 1 penalty to death saves, regardless of how many stacks you have.
Death Saves are now considered Constitution Saving Throws.

Critical Specifics

Shields on broken arms can no longer be used.
A creature that has more than the standard numer of limbs may not be affected by broekn limbs, or torn muscles.
Creatures that are already missing a limb or don't have certain body parts to critically injure (Ex: Plasmoid) instead recive Foriegn Object.

This is different from Critical Injury Immunities, which simply don't happen if rolled.

Wings are considered “legs” for the broken leg critical injury. If a creature cannot fly without one of its wings, it no longer has a fly speed and falls if it cannot be supported by the surface it is on.
A huge or larger-sized creature suffer critical injuries differently because of their size. For those creatures, do not roll the injury. When that creature is critically hit a second time, it is then critically injured. Roll the table or apply the effect as normal. This then resets.
For multiple types of damage:

Weapons that deal extra damage add the appropriate damage type critical injury to the rolled table (ex: extra fire damage, roll 1d9, on a 9, inflict the Singed condition).

Weapons that only deal one type of damage (ex: Flametongue, Sunblade) only deal critical injuries relative to their damage type.

Spells that cause multiple types of damage (ex: Meteor Swarm) roll to determine which injury is inflicted between the appropriate damage types.

The following Critical Injuries can stack infinitely.
- Foriegn Object
- Torn Muscle
- Necrosis
- Tinnitus
- Melted
- Frostbite
- Singed

Healing Critical Injuries

Quick fixes take 1 minute to apply via a Medicine or Surgeon’s Tools check.

Quick fixes last 1 hour.

Treatment/Surgery takes place over a Long Rest.

If the Surgery fails, the target does not gain the benefits of a Long Rest (but does not gain exhaustion for not sleeping).

Injuries are automatically quick fixed when taking a Short Rest (no roll required).

The timer for how long a quick fix lasts starts when the rest ends

A creature can be treated by healing the full damage of the critical hit that dealt the injury (whether all at once or in chunks) by magic.

A creature suffering from multiple critical injuries at the same time must heal through the first injury before healing through the next (excess healing from one injury carries over to the next).

Long Rests do not heal critical injuries; however, they do automatically apply a quick fix that lasts 6 hours.

Feat Bonuses

The “Tough” feat now increases your critical injury threshold by 4.
The “Durable” feat now increases your critical injury threshold by 4.
The “Heavy Armor Master” feat now increases your critical injury threshold by 6 while wearing heavy armor.
The “Vigor of the Hill Giants” feat now increases your critical injury threshold by 2.
The “Shield Master” feat now increases your critical injury threshold by 2 while using a shield.
The "Healer" feat allows you to quick fix an injury as an action once per short or long rest.