Grivious wounds (Grim Hollow)

A consistent theme throughout dark fantasy and related stories is the consequences of actions.
While the roleplay ramifications of a party's decision can be highlighted through story outcomes, combat ramifications can be a little
harder to implement. Grievous Wounds are an effective method of adding grit and realism to combat encounters, bringing the consequences of a difficult fight to the forefront of storytelling.
Implementing Grievous Wounds
Whenever a player character is reduced to 0 hit points, they roll 2d6 and subtract from the result the number of existing Grievous Wounds they have. They then apply the modified result from the Grievous Wound Table. If a player rolls the same result as one they already have a wound for, they skip this result and select the next lowest result they do not have as a wound. Results with a *
next to them can be taken more than once.
Upon completing a long rest, and if the character or someone helping them succeeds at a DC 10 Wisdom (Medicine) check, a player can remove all effects from Grievous Wounds, but not Permanent Wounds. See the next section for Permanent Wounds.

2D6 Grievous Wound
2 or less Permanent Wound. You have sustained a serious wound that is most likely permanent. Roll on the Permanent Wound Table and apply the result.
3 Internal Bleeding*. You have suffered an internal hemorrhage and bruising. Your hit point maximum is halved.
4 Concussion. You have received a minor concussion and struggle to focus on complicated tasks. You gain the dazed condition.
5 Laceration. You have taken a deep injury which you are bleeding from. You gain the bleeding condition.
6 Deep Wound*. You have taken a blow that under different circumstances would kill most humanoids. When you are reduced to 0 hit points, you start with an additional failed death saving throw.
7 Battered*. Your muscles ache and you have had the wind knocked out of you. You gain a level of exhaustion.
8 Sprained Wrist*. You have badly sprained your wrist, unable to use it effectively. You are unable to hold objects in one of your hands and you cannot take actions that require that arm.
9 Damaged Eardrum. You have suffered a blow to the head and your hearing has been impaired. You gain the deafened condition.
10 System Shock. You have suffered a
severe nervous system shock. You have
disadvantage in Dexterity checks to
determine initiative.
11 Sprained Ankle*. You have badly sprained
your ankle, unable to use it effectively.
Your speed on foot is halved and you
cannot take the dash action. If you
receive this result a second time your
speed on foot becomes 0.
12 Close Call*. You narrowly miss an
otherwise dangerous blow. Instead of
being reduced to 0 hit points, you fall to
1 hit point instead, and become prone.

Permanent Wounds
Permanent wounds are injuries that were not
lethal but left the recipient maimed. They
represent a serious impediment that requires
creativity to overcome, especially at lower levels.
The effects of a permanent wound are irreversible
unless the recipient is targeted with the regenerate
spell, upon which one permanent wound
is removed

1D6 Permanent Wound
1 Fatal Wound. Through an unrecoverable
injury you have been fatally wounded.
You are now dead.
2 Lost Arm*. You have suffered a serious
injury to your arm or have lost it entirely.
You are unable to hold objects in one of
your arms and you cannot take actions
that require two arms.
3 Lost Leg*. You have suffered a serious
injury to your leg or have lost it entirely.
Your speed on foot is halved and you
cannot take the dash action. If you
receive this result again your speed on
foot becomes 0.
4 Lost Eye*. You have lost the use of a
good eye. You have disadvantage on
Wisdom (Perception) and Intelligence
(Investigation) checks that rely on sight.
If you receive this result again, you gain
the blinded condition.
5 Scarred Lungs. Undertaking vigorous
activities causes you to break out in a
coughing fit. If you take an action, you
cannot take a bonus action until your
next turn. If you take a bonus action
you cannot take an action until your
next turn.
6 Hideous Scar. You have been horribly and
visibly scared. You have disadvantage on
Charisma (Performance) and Charisma
(Persuasion) checks. Additionally,
indifferent NPC’s may prefer not to
converse with you.