[RPG] Are there any rules for neck stabs/bleeding out

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I was a little caught off-guard during the most recent 5e session in a campaign I run, so I was hoping to get some input here. One of the players snuck up on a villainous NPC and stabbed them in the neck with the intent of killing/making them bleed out. Of course, the roll was a natural 20, so it succeeded. Not wanting to lose this NPC over a dagger's d4 worth of damage, though, I had them start bleeding. They (the NPC) had to make a Constitution save: 2d6 damage on a fail, half on a success. I'm curious, though, if there are actual rules on these kinds of situations? Would the NPC just have died outright? Are there bleeding mechanics?

Best Answer

There's a few points here. First off, even on a critical hit, it's up to DM fiat as to whether the NPC just dies outright, or takes HP damage, or whatever. If this is an important, named NPC, you probably want to have them take damage rather than just declaring them dead or dying.

If you decide to have the attack deal critical damage against HP, then do that. The player rolls all the damage dice twice and adds it up, and that's the damage dealt. Yeah, that might mean a sneaky attack from behind deals a whopping 2d4+3 damage, which is eminently survivable. (Unless the PC is a rogue, in which case it might be many d6's in addition...) If your NPC doesn't drop to zero hit points, there's not even a question -- they aren't dying. Depending on the damage dealt and the NPC's hit dice, they may not even be seriously hurt! It would be up to you as DM to describe how they sense the attack at the last moment and twist so it hits their shoulder, or something like that.

Second, yes there is a sort of 'bleeding out' mechanic built into the game; it's called a Death Saving Throw, the same as for a player who falls to zero hit points. Roll your d20 until you get three successes or three failures.

But third, if you're the DM, you decide if NPCs live or die, not the mechanics. Suppose mechanics are off the table, maybe you didn't have any stats or HP for the guy in question -- you should be the one deciding if you want to let the PC kill the NPC or have him somehow survive (and if so, how). If he shows up later with a huge scar across his neck, you don't actually have to explain what die rolls he made to do that. It just is. The game should be 'fair', but you aren't required to account for and justify every decision you make behind the scenes to advance the story.