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The help action in combat states:

You can lend your aid to another creature in the completion of a task. When you take the Help action, the creature you aid gains advantage on the next ability check it makes to perform the task you are helping with, provided that it makes the check before the start of your next turn.

Alternatively, you can aid a friendly creature in attacking a creature within 5 feet of you. You feint, distract the target, or in some other way team up to make your ally’s attack more effective. If your ally attacks the target before your next turn, the first attack roll is made with advantage.

In a round of combat:

  • an NPC, Aiden, uses the help action to aid Charles to attack against an enemy orc
  • an orc attacks Charles hitting him down to 0hp
  • Arthur attacks the orc
  • Barton attacks the orc
  • Charles starts making death saves
  • back to Aiden

What happens to Aiden's help action during this round? Since Aiden's ally doesn't attack the target before Aiden's next turn, is it lost? Can he switch it out to help with the death save or is it "locked in" during Aiden's turn of that round?

Would the ally actually be nominated as part of Aiden taking the action at the top of the round; is the help action for one specified ally, or for any single ally attacking before my next turn?

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If Aiden uses the Help action to give someone advantage when attacking an enemy, that is the only effect that Help action has; it doesn't give any ally advantage on an ability check, since Aiden already decided to use it to gain advantage in attacking a creature.

However, according to Jeremy Crawford, the Help action does not need to specify a particular ally to gain the benefit:

If you use the attack-aiding option in Help, the next ally who attacks the target gets the benefit.

So, in your example, Aiden would use the Help action to assist a friendly creature (any single one) in attacking the specified enemy orc (which must be within 5 feet of him when he uses the Help action to grant advantage on an attack). The orc would then reduce Charles to 0 HP.

However, when Arthur attacks the orc, he will have advantage (assuming there's nothing else that would give him disadvantage), because that's what the Help action does; it distracts an enemy in order to give an ally (any ally) a better chance to hit.

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  • \$\begingroup\$ The fact that "it does not need to specify a specific ally" is not at all clear from the rule. If the rule was intended to mean that, it is horribly written. And if Jeremy implies that it clearly means that, it is a bent interpretation. \$\endgroup\$
    – Yakk
    Apr 19, 2018 at 19:06
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    \$\begingroup\$ Nothing about the rule mentions a specific ally. I don't see how it's "bending" the rule to clarify that it doesn't have to be a specific ally; it's just slightly ambiguous wording, that Crawford has since clarified. In any case, this seems like a conversation for chat. Related: Do I choose the target or the ally for the Help action? \$\endgroup\$
    – V2Blast
    Apr 19, 2018 at 19:11
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It's not "lost" as such. But you can't magically turn it into something else because circumstances changed.

If your ally attacks the target before your next turn, the first attack roll is made with advantage.

That's all the Help action (when used to Help an attack) does. If your ally doesn't attack, it doesn't change the fact that you used the Help action. You used it, it's too late to change your mind.

As for other allies taking advantage (get it?) of the Help action in the incapacitated ally's absence, this unfortunately won't work either.

If your ally attacks the target before your next turn, the first attack roll is made with advantage.

Not "if one of your allies" or "if any of your allies", but "if your ally". You take the Help action to assist a specific ally, and only that ally can benefit from it.

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    \$\begingroup\$ You can't get your damaged Help action refunded under warranty, basically. \$\endgroup\$
    – Sebkha
    May 9, 2016 at 13:36
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    \$\begingroup\$ A correction - according to Jeremy Crawford, you don't need to specify which friendly creature gains advantage from the Help action. It's just the next friendly creature to attack the specified target: twitter.com/JeremyECrawford/status/854020028949086208 \$\endgroup\$
    – V2Blast
    Jan 31, 2018 at 9:57

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