All similar questions I've found are concerned with what happens if combat ends while there is an unconscious PC, but I can't find any rules regarding what happens if someone drops to 0 HP while the party is not in combat and doesn't have an established turn order (for example because of a trap or a fall).

Does the party have to roll initiative and establish a turn order just for the sake of death saving throws and stabilization? Or is there a more loosely structured way to handle this?

up vote 9 down vote accepted

You could roll initiative

One way of resolving this is to roll initiative. This at least resembles how it would be handled in (or at the end of) combat. However, as you say, it does seem a bit excessive...

Or act out of initiative

If one of the party has spare the dying or a healing spell, or a healing potion, then this becomes trivial, since they cast the spell and then no-one is dying. Even if the dying PC rolled a 1 on their death saving throw, they're back up (or at least stable) thanks to one casting of a spell.

However, if no-one has those spells, then it's down to death saving throws and medicine checks. This therefore becomes a skill challenge rather than a combat scenario. This does not need to involve the entire party, so initiative becomes irrelevant.

Rather than having everyone dogpile the fallen PC with Medicine checks (see this question about skill checks and why it's not a great idea to have everyone repeatedly try the same skill check), it makes sense if the PC with the highest Medicine check (perhaps helped by another PC via the Help action, which gives advantage on the check) trying to stabilise the fallen PC as the PC is making death saving throws, alternating between them.


@Yakk has pointed out in comments that this makes stabilising a dying PC harder than it would if everyone were allowed a try, as is commonly ruled during combat, but I would argue that, from a narrative perspective, this doesn't make much sense. Given that rounds of combat are 6 second, stabilising someone within 6 seconds is already cutting it fine, but if each member of a party of 4 trying to revive their dying party member, what does that look like?

Are they all attempting it separately? That means either each gets 2 seconds to try before the next one has a go, which doesn't sound plausible to me, or they're all stepping over each other to simultaneously individually try to stabilise their friend, in which case I'd almost want to impose disadvantage on them for that. However, if we assume that the party are collaborating in their efforts to revive their friend, then I'd say that's what the Help action represents, and thus grants advantage on the one with the highest Medicine skill.

  • Do you intend in your last paragraph to make saving someone at 0 HP harder outside of combat than in it? (as in combat, you can clearly have more than one person try to stabalize) – Yakk Aug 17 at 17:47
  • @Yakk Actually, I've come up with a better argument. I'll include that in my answer. – NathanS Aug 17 at 18:15

The rules for death saving throws still apply, but its just up to you as a DM to arbitrate the timing.

If there is nobody around to help then you can just call for the PC to make their death saving throws until they stabilise or die.

If there is a chance someone may arrive to help then you can make a reasonable decision on how long that takes (and perhaps call for, say, one or two saves before the arriving character has a chance to do something if it matters or just for drama).

If a helper has healing magic then the situation can just be resolved. Otherwise you can just say the helper has a chance to make a medicine check in between death saving throws. Exact order doesn't really matter at this point.

Initiative is built in

The order is:

  1. The trap
  2. The victim
  3. The rest of the party

The trap acted first with its damage. The victim (now at 0 hp) gets a round to roll their first death saving throw. Then the party as a unit gets a round to come up with a plan to help the victim (cast a spell, move to the victim to apply direct aid, last rites, etc). Just make sure that any action the party does is timed to "1 Action". Also, the party should act as one unit, not everyone going down the line with Medicine checks. However something like, "The fight gets out a rope, ties it to himself and throws the other end into the pit. The bard helps steady the line, and the cleric repels down to cast cure light wounds," is perfectly fine.

Top of the order.

The trap, generally once sprung, is done. However some traps can be reset or have a repeated threat. In this case things get messy1. If it has nothing then the trap "holds its action" for this round. The victim gets another death saving throw, and finally the party gets to act again. Rinse and repeat until saved or dead.

1 Technically, since the trap is most likely within 5ft of the victim, if it does do secondary damage it would count as an automatic critical hit and give two failed saving throws. To get to this point, the victim would have failed the first immediate saving throw and this would bring the count to three fails and perma-death. Unless the DM is feeling vindictive, I would only count this as one failure and give the player one more roll to try and save his/herself. Or give the party until the end of the round to save them.

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