House rules for death (or near death) in Labyrinth Lord

I like running and playing games where the world is deadly. But, sometimes just saying "you're at negative 1 HP, you're dead, re-roll" is as boring as playing supermen that cut through swathes of enemies without a scratch. Near-death ( and alternatively near-not-death) open up a world of role playing possibilities, drama and emergent game play.

The most important thing here is that the conscious players have the opportunity to DO SOMETHING to help their dying companion. It doesn't have to be medically correct, unless your group is all doctors/nurses and you get off on that, it just needs to be SOMETHING. Best case scenario that SOMETHING is entertaining, creates drama and depletes a player resource (more than likely time). Get the players thinking about what they would and could do in a fantasy world to help some one at Death's door. It can be outrageous, silly, possibly even deadly but just getting them doing SOMETHING to save their dying companion will pull them into the world. It makes the prospect of death more realistic (unless your letting them heal wounds with bananas) by turning it into a role playing process rather than an arbitrary game mechanic.

Vanilla Labyrinth Lord (and therefore early iterations of D&D) is pretty blunt; get below 0 and you're dead. This is my house rule for dealing with dying characters;

Once a character gets to 0 or below HP they are unconscious. Have them make a CON save. For each negative HP they have add 1 to their roll (their trying to roll UNDER their CON, so this is a bad thing).

If they fail it, roll a d6, that's how many more HP they lose. Give the other conscious player's some tells that the passed out character's condition is getting worse: more blood gushing out, vomiting, choking etc. See if they do anything to help the situation. Depending on what they do (bandage the wound, turn the character on their side to let the vomit escape their throat, step on the character, wander off) the character receives a bonus or a negative to their next CON save. Roll that next CON save, if they make it, see below. If they fail it, repeat the process above (another d6 of damage, another check to see if the party helps) until they are below the negative equivalent of their HP. At that point they're well and truly dead (unless a player comes up with something spectacular, then go with that).

If they make the CON save, they're stabilized. Unconscious, possibly bleeding to death, but stabilized. They're a useless, helpless sack of meat at this point. It's up to the other player's to do something. If they just ignore the passed out character (not bandaging the wound, not turning the character on their side, running around with their hands in the air) get the player to make another CON save. Add some numbers to whatever they roll depending on the severity of the other character's negligence. If they fail it, and continue to be ignored by the other characters, they can just keep failing CON saves until they're below the negative equivalent of their HP. At this point they are really dead.

If a character makes three consecutive CON saves, even with gross negligence of the other party members, they have stabilized themselves through some subconscious will to live. They will awake, hurting all over but alive, in 24 hours. Their dickhead party members have probably left them to rot, or buried them alive. The unconscious form is going to have to survive the nights random encounter checks.

If the character makes their CON save, becomes stabilized and given reasonable medical attention by their fellow party members they will be unconscious but stable for the next 12 hours. They are not out of the woods yet. Have them make an additional 2 CON saves over those12 hours. Add a bonus you think appropriate for the care the other members have given them (remembering to factor in the amount of negative hit points they have). If they fail any of the saves, roll a d6 and apply the damage. This process continues until they pass 2 consecutive CON saves or they die by exceeding a negative equivalent of their HP.

If they live, by making those CON saves, they wake up in 12 hours at 1 HP and in a world of hurt.

Bring a Cleric next time.