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The Half-Orc class on PHB page 41 has a trait which states the following:

Relentless Endurance. When you are reduced to 0 hit points but not killed outright, you can drop to 1 hit point instead. You can’t use this feature again until you finish a long rest.

But what exactly is meant by not getting killed outright? Can you only use this when the damage is ongoing damage that puts you at 0 hit points? When exactly does this trait activate?

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If you read the Dropping to 0 Hit Points section of the PHB/Basic D&D rules, you'll find the following paragraph:

Instant Death

Massive damage can kill you instantly. When damage reduces you to 0 hit points and there is damage remaining, you die if the remaining damage equals or exceeds your hit point maximum (Player's Basic p76)

Thus, the "killed outright" that the Half Orc's racial feature is referring to here is overdamage equal to your Hit Point max.

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    \$\begingroup\$ It should also be noted that you can be killed outright in situations outside the confines of combat and HP abstraction. For example, getting your head cut off in a guillotine kills you outright. You don't get up from that with one hit point left. \$\endgroup\$ – Mike Riverso Jan 9 '15 at 1:14
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    \$\begingroup\$ Per Sage advice July 2016, disintegrate is also an instance of being killed outright, no returning to 1 HP. \$\endgroup\$ – nitsua60 Jul 19 '16 at 17:08
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    \$\begingroup\$ You can add Power Word Kill to this list of being killed outright. It doensn't even reduce your HP, you just die if you have less than 100. \$\endgroup\$ – Lino Frank Ciaralli Mar 6 '18 at 21:32
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Being killed outright here means simply dying, without any opportunity to be saved. For instance, when a PC is dealt enough damage to be dropped to 0 hit-points, and the remaining damage is greater than that PC's maximum hit-points, they simply die on the spot, without any death saving throws made or any stabilizing opportunity. Additionally, if a PC is in a dying state, making death saving throws every one of their turns, and they take damage greater than or equal to their max hit-points, they die automatically with no save.

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"Killed outright" is referring to any kind of instant death, rather than incapacitated and bleeding out.

In addition to massive damage (enough to reduce you to negative HP equal to your original HP max in a single blow), Wraiths also can kill you outright - they reduce HP max with their strikes, and being reduced to 0 HP max is instant death.

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