DnD 3.5 Surgery V.2 P.E.A.C.H. Work in progress

[Kiren]

Welcome to my complete rewrite of my dnd 3.5 surgery mechanics designed to replace divine magic in terms of healing ailments, generally made for more realism and replacement of heal. This is a work in progress and much needs to be written, but I need fair, harsh criticism, im used to it from the last time I tried this. Good times.



Without further adue.

Dungeons and Dragons Field Issue Surgical Guide
-Alternatively DnD Surgery, dare I say second opinion?

Introduces alternate rules designed to replace the heal skill and divine magic as primary means of healing.

New classes

Surgeon Class

Alignment- Any
Hit Die- d6

Class Skills
The Surgeon's class skills (and the key ability for each skill) are Balance (Dex), Concentration (Con), Craft (Int), Surgery(Dex), Profession (Wis), Sleight of hand (Dex), Spot (Wis), Survival (Wis), Use rope(Dex),

Skill Points at 1st Level
(6 + Int modifier) ×4.

Skill Points at Each Additional Level
6 + Int modifier

{table=head] Level | Base Attack Bonus | Fort Save | Ref Save | Will Save | Special Abilities
1 | +0 | +0 | +2 | +0 | Surgical Training, Vital Strike +1d6
2 | +1 | +0 | +3 | +0 | Combat Surgery, Surgical Bonus Feat
3 | +1 | +1 | +3 | +1 | Mobile Healing
4 | +2 | +1 | +4 | +1 | Vital Strike +2d6
5 | +2 | +1 | +4 | +4 | Surgical Bonus Feat
6 | +3 | +2 | +5 | +2 | Death's Doctor
7 | +3 | +2 | +5 | +2 | Self Surgery, Vital Strike +3d6
8 | +4 | +2 | +6 | +2 | Poison Use
9 | +4 | +3 | +6 | +3 |
10 | +5 | +3 | +7 | +3 | Vital Strike +4d6
11 | +5 | +3 | +7 | +3 |
12 | +6/+1 | +4 | +8 | +4 |
13 | +6/+1 | +4 | +8 | +4 | Surgical Bonus Feat
14 | +7/+2 | +4 | +9 | +4 | Vital Strike +5d6
15 | +7/+2 | +5 | +9 | +5 |
16 | +8/+3 | +5 | +10 | +5 |
17 | +8/+3 | +5 | +10 | +5 | Surgical Bonus Feat
18 | +9/+4 | +6 | +11 | +6 |
19 | +9/+4 | +6 | +11 | +6 | Vital Strike +6d6
20 | +10/+5 | +6 | +12 | +6 | Surgical Bonus Feat[/table]


Thanks Elistan for the Table



Surgical Training-
Allows points to be spent in the surgery skill and enables the character to perform surgical techniques stated under the Surgical Mechanics section.

Vital Strike-
A surgeon can hit precisely on the vital areas of their enemies, when given the chance to target. The Surgeon’s attack deals extra damage any time her target would be denied a Dexterity bonus to AC (whether the target actually has a Dexterity bonus or not), or when the surgeon flanks her target. Should the surgeon score a critical hit with a sneak attack, this extra damage is not multiplied.

Ranged attacks can count as vital strikes.


A surgeon can sneak attack only living creatures with discernible anatomies—undead, constructs, oozes, plants, and incorporeal creatures lack vital areas to attack. Any creature that is immune to critical hits is not vulnerable to vital strikes. The surgeon must be able to see the target well enough to pick out a vital spot and must be able to reach such a spot. A surgeon cannot vital strike while striking a creature with concealment or striking the limbs of a creature whose vitals are beyond reach.

Surgical Bonus Feat-
On levels 2, 5 13, 17, and 20 the surgeon gains a new surgical bonus feat

Combat Surgery-
Combat surgery allows the surgeon to take combat actions during a round surgery is performed, if the surgeon has the appropritate action avalible.

Mobile Healing-
The surgeon can now move their patient during a round with surgery actions, at half the surgeons move speed.

Death's Doctor-
The surgeon knows all the vital points of the body and can strike down their targets accordingly, If a Surgeon studies his victim for 3 rounds and then makes a vital strike that successfully deals damage, the sneak attack has the additional effect of possibly either paralyzing or killing the target (surgeons’s choice). While studying the victim, the surgeon can undertake other actions so long as his attention stays focused on the target and the target does not detect the surgeon or recognize the surgeon as an enemy. If the victim of such an attack fails a Fortitude save (DC 10 + the surgeons’s class level + the surgeon's dex modifier) against the kill effect, she dies. If the saving throw fails against the paralysis effect, the victim is rendered helpless and unable to act for 1d6 rounds plus 1 round per level of the surgeon. If the victim’s saving throw succeeds, the attack is just a vital strike attack. Once the surgeon has completed the 3 rounds of study, he must make the death attack within the next 3 rounds.

If a death attack is attempted and fails (the victim makes her save) or if the assassin does not launch the attack within 3 rounds of completing the study, 3 new rounds of study are required before he can attempt another death attack.


Self Surgery-
A surgeon has achieved such expertise that they may perform surgery on themselves at a -10 to the surgery skill.

Poison Use
After exposure to many syringes and anestetics, you never risk accidently poisoning yourself.







Surgical Mechanics

New Skills-

Surgery (Dex, Trained only)
The surgery skill is used for treating wounds determining the effectiveness of surgical feats.

Multiple points increase your Accuracy and Cure rolls outcome, every 3 points adds 1 to the outcome.

Knocking out or Restraining the Patient
Getting cut with a knife without the ever-so helpful chemical adrenaline is not the best way to spend your day, this section includes how to successfully keep the patient knocked out and the surgeon not sued or beheaded for malpractice.

Magic/Psionics/Other
If Magic or Psionics is included within your campaign (surgery is designed for low magic settings or settings lacking divine magic), a patient may have their pain dulled (by a spell such as lullaby) or knock them out (by a spell such as sleep), but are not limited to these spells.

Physical Force
Dealing nonlethal damage accumulating to more then the patients hitpoint total will successfully knock them out. (Nonlethal damage recovers overtime, if the patient's nonlethal damage recovers enough, they will wake up mid surgery.

Rope/Held down
When you really can't be bothered.... well there is rope. Rope has no ability to dull pain but you can perform surgery without the patient moving and/or screaming, quite the harsh option considering physical force is free. A patient can also be held down with the use of at least one other person in a successful grapple with the patient.

Anesthesia
Anesthesia's effectiveness varies depending on the kind used, but is usually the most effective method. Check under new items for the Anesthetics. Administering a Anesthetic varies from Anesthetic to Anesthetic.

Going without
When their is really no other option, the surgeon can opt to do without. When going without anesthetic a surgeon takes a -10 penalty to the surgical skill.

Other
Other methods to knock out a patient are viable with DM permission.

Surgical Rolls

Accuracy Roll: An accuracy roll determines if a surgeon addresses a problem successfully, in order to begin treating a problem, the surgeon must roll against the Acuracy Difficulty (AD), accuracy rolls are done by D20, natural 20's will double the outcome of the cure roll. Missing a Accuracy roll requires the user to roll a Mishap. An Accuracy roll increases by 1 for every 3 points in the surgery skill.

Cure Roll: While a Accuracy Roll addresses a problem successfully, the Cure roll represents how much effect the treatment has. In order to advance to the next stage of the surgery, the surgeon must surpass the Cure Point Quota (from this point on CPQ) of the step. A cure roll using normal tools uses a 1d6 while a cure roll using makeshift tools will impose a -2 penalty on the roll and limit the dice to 1d4. A cure roll increases by 1 for every 3 points in the surgery skill.

Mishap Roll: A mishap happens and when it does, when an accuracy roll is failed roll 1d10 with a -1 bonus for every 4 points of con modifier of the patient and apply the outcome as vital damage. Using makeshift tools or going without any form of patient restraint adds one dice to the mishap roll, (so with both you have a 3d10 mishap roll, tough luck).

Vitals
Vitals represent the condition of the patients body during surgery, the base maximum vitals for a character is 100 with a +5 to every point of Constitution above 10, with a penalty of -5 for every point below 10 con. Characters recieve vital penalties depending on their hitpoint damage, from full to above 3/4th their is no penalty from hitpoints, from 3/4 to above 2/4 is a -10 vital reduction, 2/4 to above 1/4 is another -10 reduction, 1/4 to above 0 health is another -10, when a character has no hitpoints or negative hitpoints they have another reduction to vitals by -10. (a character with half health will have 80 starting vitals before the condition reduction while a character below 0 hitpoints will have 60 starting vitals). In addition to a hitpoint penalty from health, some conditions will also lower vitals, somethings are not easy to live through.When vitals drop to 0 the patient dies. A patient with no ailments (or benign) will recover vitals at a rate of 2 per hour.

Critical Injuries- Critical hit replacement
Critical injuries are aliments that require a surgeon (or magic) to fix. If a enemy rolls 20 and confirms with another 20 then the DM must roll 2d20 on the critical injury table below. (* When attacked by weapons or objects that are coated or dispense a harmful substance or ailiment, removal of that substance may be required*)

2: Fumble (Roll damage to self)
3-10: Nothing
11-12: Broken Bones ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
13-16: Lacerations (Roll 1d4 1-2: External, 3-4: Internal)
17-20: Foreign Object
21-26: Fracture ( Roll 1d6 1=Arm left 2= Arm Right 3= Leg left 4= leg right 5 = chest 6= skull)
27-34: Loss of Minor body part (roll 1d10 1:Eye L. 2:Eye R. 3:Finger left hand 4:Finger Right 5:Toe L. 6:Toe R. 7-10: None lucky break.
35: Loss of majior body part (Roll 1d4 1=Arm left 2= Arm Right 3= Leg left 4= Leg right )
36-40: Roll twice and take both, reroll on conflicting injuries (Fracture and break on same limb, however a broken left arm and detatched left arm is compatible)

Alternatively you can use this variant for 1d6
1-2: Nothing
3-4: Fumble (Roll damage to self)
5-6: DM chosen injury

Complications-
If a Surgeon makes a mishap it adds one complication point, if enough complication points add up to match to complication quota further work will be required to correct surgeon error, this varies from ailiment to ailiment. If using makeshift tools add one more complication point for every mishap, another is the patient is unrestrained.

First Incision-
The first incision is required for most ailiments with internal damage, the accuracy difficulty for a first incision is 10 with a +1 for every point of natural armor the patient has. No cure roll is required and their is no chance of mishap.

Combat during Surgery-
A surgeon cannot perform combat actions and surgical actions in the same round, a patient can also not be moved and cannot attack during a round they are being performed on. The Combat Surgery ability enables these.

Procedures


Acid Draining
Procedure:
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Acid: Time: Standard Action AC: 8 CPQ: 4
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemorrhaging
Starting Vital Reduction: -5

Arrow/Bolt Removal
Cut off Edges of Arrow/Bolt: Time: Full Round Action AC: 14 CPQ: 6
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15


Broken Bones
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10

Bullet Removal (Shuriken/Pellets)
*Optional* First Incision (Internal Bullets only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Bullet: Time: Standard ActionAC: 14 CPQ: 3
OR
Removal of Shrapnel: Time: Full Round Action AC: 15 CPQ: 5
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Bullets only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15


Burn treatment
*Optional* First Incision (Internal Burns only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10

Eye Reattachment
*Reattached Eye need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the eye from the donor, whichever comes first.
Draining the Blood from socket: Time: Standard Action AC: 8 CPQ: 4
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Reconnect eye to socket: Time: Full Round Action AC: 13 CPQ: 4
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -20

Lacerations
*Optional* First Incision (Internal Lacerations only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Lacerations only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -5

Foreign Object Removal
*Optional* First Incision (Internal Objects only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of object: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Objects only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -15

Infection
*Optional* First Incision (Internal Infection only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 3
Complications: Hemorrhaging
Starting Vital Reduction: -15

Hemorrhaging
*Optional* First Incision (Internal Hemorrhaging only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
*Optional* Stitching the first incision (Internal Hemorrhaging only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 5
Complications: Infection
Starting Vital Reduction: -5

Limb Reattachment
*Reattached limb need not be your own, just as long as the operation begins within an hour of either the death of the donor or the removal of the limb from the donor, whichever comes first.
Wrap remaining attached limb tight: Time: Swift Action AC:0 CPQ:1
Stitch the limb onto body: Time: Full Round Action AC: 15 CPQ: 5
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Re-align the bone: Time: Standard Action AC: 8 CPQ: 2
Burn the bone together: Time: Standard Action AC: 14 CPQ: 5
Reconnect veins: Time: Standard action AC: 14 CPQ: 5
Stitch veins: Time: Full Round Action AC: 18 CPQ: 8
Reconnect Nerves: Time: Full Round action AC: 15 CPQ: 5
Stitch Nerves: Time: Full Round Action AC: 18 CPQ: 8
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Wrap the wound lightly: Time: Swift Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging, loss of limb
Starting Vital Reduction: -20

Limb Removal
Wrap limb tight: Time: Swift Action AC:0 CPQ:1
Remove the limb: Time: Full Round action AC:14 CPQ:6
Stitch extra skin to remaining limb: Time: Full Round Action AC: 14 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Unwrap tight wrap:Time: Free Action AC:0 CPQ:1
Complication Quota: 2
Complications: Infection, hemorrhaging
Starting Vital Reduction: -0
Surgery End Vital Reduction: -20 (1d10 days)

Mummy rot Curing
Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1

OR

External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stiching the wound: Time: Full Round Action AC: 12 CPQ: 3

Complication Quota: 3
Complications: Infection, hemoraging,
Starting Vital Reduction: -10


Parasite Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of Parasites:
Removal of affected tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Hemorrhaging
Starting Vital Reduction: -10


Poison draining
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Draining the Poison: Time: Standard Action AC: 8 CPQ: 4
Removal of Poisoned tissue: Time: Full Round Action AC: 14 CPQ: 6
Draining the Blood: Time: Standard Action AC: 8 CPQ: 4
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stiching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound:Time: Swift Action AC:0 CPQ:1
Complication Quota: 4
Complications: Infection, Burns or Hemoraging
Starting Vital Reduction: -5


Slimy doom Removal

Internal Based Infection
First Incision (Internal based infection only only): Time: Swift Action AC: 10+Natural Armor CPQ: None
Removal of infection cause: Time: Full Round Action AC: 14 CPQ: 6
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Stitching the first incision (Internal Infection only): Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1

OR

External Based Infection
Reopen/drain the wound: Time: Standard Action AC: 8 CPQ: 4
Removal of wound tissue: Time: Full Round Action AC: 14 CPQ: 6
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3

Complication Quota: 3
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -15



Tumor Removal
First Incision: Time: Swift Action AC: 10+Natural Armor CPQ: None
Cut tissue to tumor: Time: Swift Action AC: 10 CPQ: 2
Drain/clean the area: Time: Standard Action AC: 8 CPQ: 4
Cut around tumor: Time: Standard Action AC: 10 CPQ: 4
Removal of Tumor: Time: Standard Action AC: 8 CPQ: 2
Stitching the wound: Time: Full Round Action AC: 12 CPQ: 3
Stitching the first incision: Time: Full Round Action AC: 12 CPQ: 3
Wrap the wound: Time: Swift Action AC:0 CPQ:1

Complication Quota: 4
Complications: Infection, hemorrhaging,
Starting Vital Reduction: -10








New Items
Its widely known that knives hurt, especially the dull and blood covered ones, when performing surgery remember a couple of things, a surgeon is half skill, half equipment, the second one is never let the barbarian handle the surgery.


Tools

Surgeons Kit
Cost:100 Gp
Removes all penalties for working with improvised tools, since.... well these are the tools.

Trauma Kit
Cost:500 Gp
+ 2 bonus to surgery skill, removes all penalties for working with improvised tools




Knock out Anesthetics

Mild Anesthetic
Cost: 20 Gp per dose
Knocks out a medium individual for an hour, (small: 2 hours, Large: Half an hour)


Dwarven water
Cost: 50 Gp per dose
Knocks out a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)


Dwarven king's brew
Cost: 80 Gp per dose
Knocks out a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)

Pain Dulling Anesthetics

Minor Pain killer
Cost: 40 Gp per dose
Dulls the pain for a medium individual for an hour, (small: 2 hours, Large: Half an hour)
Medium: -2 to hit roll (Small: -4, Large: -1)


Medium pain killer
Cost: 100 Gp per dose
Dulls the pain for a medium individual for an 2 hours, (small: 4 hours, Large: 1 hour)
Medium: -4 to hit roll (Small: -8, Large: -2)


Heavy pain killer
Cost: 160 Gp per dose
Dulls the pain for a medium individual for an 4 hours, (small: 8 hours, Large: 2 hour)
Medium: -8 to hit roll (Small: -16, Large: -4)




New Feats

Surgical Feats

Part time surgeon (Surgical)
Effect: Allows a non surgeon to take ranks in surgery and perform surgery.

[Kiren]

Reserved for space

[Elistan]

Try this for the class, Kiren. Just quote this, and then copy it into the first post.

{table=head] Level | Base Attack Bonus | Fort Save | Ref Save | Will Save | Special Abilities
1 | +0 | +0 | +2 | +0 | Surgical Training, Vital Strike +1d6
2 | +1 | +0 | +3 | +0 | Combat Surgery, Surgical Bonus Feat
3 | +1 | +1 | +3 | +1 | Mobile Healing
4 | +2 | +1 | +4 | +1 | Vital Strike +2d6
5 | +2 | +1 | +4 | +4 | Surgical Bonus Feat
6 | +3 | +2 | +5 | +2 | Death's Doctor
7 | +3 | +2 | +5 | +2 | Self Surgery, Vital Strike +3d6
8 | +4 | +2 | +6 | +2 |
9 | +4 | +3 | +6 | +3 |
10 | +5 | +3 | +7 | +3 | Vital Strike +4d6
11 | +5 | +3 | +7 | +3 |
12 | +6/+1 | +4 | +8 | +4 |
13 | +6/+1 | +4 | +8 | +4 | Surgical Bonus Feat
14 | +7/+2 | +4 | +9 | +4 | Vital Strike +5d6
15 | +7/+2 | +5 | +9 | +5 |
16 | +8/+3 | +5 | +10 | +5 |
17 | +8/+3 | +5 | +10 | +5 | Surgical Bonus Feat
18 | +9/+4 | +6 | +11 | +6 |
19 | +9/+4 | +6 | +11 | +6 | Vital Strike +6d6
20 | +10/+5 | +6 | +12 | +6 | Surgical Bonus Feat[/table]

[Kiren]

Thanks for the table, the code I was using for tables was more complex.

[Kiren]

Bump for space

[TabletopNuke]

Wow. You've done a lot of work here! How long did this take?

My instant reaction was "YES! DO WANT!". In my Breakdown setting, human society lacks magic, relying on modern surgical techniques. I've been working on something similar (although much less complicated), but didn't get far enough along to post it. Though I will happily share what I've made if, you want.

That said, this seems veeery complicated for the purposes of a typical D&D game. While I will quickly admit that the current Heal skill is a bit too simple, most players wouldn't be patient enough for this. I'd hate to discard so much hard work, though (as I'm sure you would), so I will say that this could be adapted into a tabletop version of Trauma Center. ;)

My combat medic homebrew (that I never got around to posting) was based on the rogue, granting sneak attack, like yours, as well as Complete Scoundrel's ambush feats. I'm sure doctors know all the good places to stab somebody.

While I do think that we need a variant of critical hits for bone breaking and such, I've heard complaints from players over particularly complicated crit-injury tables. So you'd definitely need to get the okay from your fellow gamers before using it.

Also, is Surgery replacing Heal? Surgery is not the same as treating a condition with medicine. I suggest adding a Wis based skill like "Heal" or "Medical Treatment" (you can probably come up with a better name) for
I think Sugrery should provide a skill synergy bonus to the other skill, and vice versa.

[Kiren]

I did this for a few hours over 5 days.

My previous surgery attempt to replace heal suffered from the complexity too, although this time around I attempted to make it more like combat. The surgeon class is not quite finished yet though

And yes, I did base most of this off of trauma center, and a few trauma center themed things will come in time.

Surgery is replacing heal, i've been thinking from time to time about making a medical based assortment of classes and rules though.

If you have any suggestions how I can make this run smoother though im open to changing it up to make it work better for campaign use. (Since whats the point of a mechanic if no one wants to bother with it lol)

[jiriku]

Neat!

General Feedback: The rules for using the surgery skill were so complicated that my eyes glazed over and I hit page down repeatedly looking for something more interesting to read. I think that might be something only a pre-med student could love.

I still need to see those surgical bonus feats to be sure, but based on what you have here, this is not a 20-level class. This is 3 levels of rogue, 2 of assassin, a 5-level surgeon prestige class, and 10 dead levels. I'd rank it as a Tier 6 class, approaching Tier 5 if the surgical bonus feats are good. If you're building for a low-power, low-magic campaign world (and I assume you are, given the premise of a surgeon class), that's probably alright, but this class will be overshadowed by basically every other class in the game.

Some suggestions:

You need more class skills. A human surgeon with high Int will have more skill points to spend at each level than he has class skills to spend them on (unless he buys a series of Craft or Profession skills, which is quite rare). I'd recommend Bluff, Diplomacy, and Sense Motive, to represent a doctor's general bedside manner and skill at diagnosis, plus the gravitas and authority that doctors carry in settings with limited access to skilled medical care. Add Knowledge (religion), because doctors often conducted burial rites as well. Knowledge (local) and Knowledge (geography) might be appropriate because the everyone has a use for a surgeon's skills sooner or later, so a surgeon knows everyone and travels everywhere. Autohypnosis would be useful and thematically appropriate. Likewise, add Ride, because when someone runs into town to tell you that Betty Sue's labor has started two weeks early and the baby isn't coming, you don't walk to that appointment - you ride as fast as you can.

At higher levels, you need the ability to do more stuff. Even the lowly monk gains the ability to jump off cliffs, walk through walls, and kill with a touch, while your surgeon basically gets...nothing. At all. Just some minimal improvements to skills he already has so that they remain relevant. High-level D&D is amazingly heroic! He should be blinding, paralyzing and insta-killing foes with a paper clip, performing complex field surgery with a sharp rock and some chewing gum, using his knowledge of chi points and acupuncture to remove curses, and hand-mixing unusual reagents and elixirs with his advanced knowledge of chemistry/alchemy/drugs. Think big, and give him some truly amazingly cool abilities for his highest levels.

[Kiren]

Thank you for the feedback, I understand that it is overly complex and that the current work I have done is more suitable for Trauma Center:D20 lol.

I'm working on a simpler way to implement it and I might have found it. This feedback is incredibly helpful and I will get straight to work, thanks.

Edit: Also correct, assassin + rouge + original surgeon abilitys

And the class wasn't quite complete, I had hit a roadblock.

[TabletopNuke]

If your system is best suited to Trauma Center d20, then make it!

Here's the combat medic class I started (inspired/influenced by BRC's Doctor class). I never posted it because I'm still figuring out the Heal still (split into Surgical and Medicine subskills?).

I made it for my Breakdown setting, in which the human world is fairly similar to ours. There is no healing magic (or any magic for that matter) in human society, just modern medicine. This is why the combat medic's healing ability won't be anywhere near the ability of a cleric or healer. As a result, I had to up the combat ability so the class wouldn't sink into the forgotten depths of tier 6 classes.

So, yeah. Getting hurt is Breakdown isn't good for normal human, or even melee humans for that matter.

Feel free to rework to serve your needs, or base you own class on it. Just give me credit, please. Lemme know if this helps.

Combat Medic

Spoiler

Show

Game Rule Information:
Abilities: Wisdom is arguably the most important ability for a combat medic, as it improves the Heal skill. Dexterity is also useful for the lightly armored combat medic. It also improves otherwise lacking Reflex saves. Constitution is helpful to boost the combat medic’s mediocre hit points.
Alignment: Any
Hit Dice: D6
Class Skills: Appraise (Int), Bluff (Cha), Concentration (Con), Craft (Int), Diplomacy (Cha), Gather Information (Cha), Handle Animal (Cha), Heal (Wis), Intimidate (Cha), Knowledge (Nature) (Int), Listen (Wis), Profession (Wis), Search (Int), Spot (Wis), Survival (Wis)
Skill Points at 1st Level: (6 + Int modifier) X 4
Skill Points at Each Additional Level: 6 + Int modifier

Combat Medic
{table=head]Level|Base Attack Bonus|Fort Save|Ref Save|Will Save|Special

1st|

+0

|

+2

|

+1

|

+2

|Skill Focus (Heal), sneak attack +1d6,

2nd|

+1

|

+3

|

+0

|

+3

|Bonus Ambush Feat, medical expertise

3rd|

+2

|

+3

|

+1

|

+3

|Sneak attack +2d6

4th|

+3

|

+4

|

+1

|

+4

|Deadly precision +1, patch up

5th|

+4

|

+4

|

+1

|

+4

|Sneak attack +3d6

6th|

+4

|

+5

|

+2

|

+5

|Bonus Ambush Feat, vitality

7th|

+5

|

+5

|

+2

|

+5

|Sneak attack +4d6

8th|

+6/+1

|

+6

|

+2

|

+6

|Healing mastery, resourceful treatment

9th|

+6/+1

|

+6

|

+3

|

+6

|Sneak attack +5d6

10th|

+7/+2

|

+7

|

+3

|

+7

|Bonus Ambush Feat, defensive roll

11th|

+8/+3

|

+7

|

+3

|

+7

|Sneak attack +6d6

12th|

+9/+4

|

+8

|

+4

|

+8

|Deadly precision +2, medical guidance (one-half penalty)

13th|

+9/+4

|

+8

|

+4

|

+8

|Bonus Ambush Feat, sneak attack +7d6

14th|

+10/+5

|

+9

|

+4

|

+9

|Quick treatment, crippling strike

15th|

+11/+6/+1

|

+9

|

+5

|

+9

|Sneak attack +8d6

16th|

+12/+7/+2

|

+10

|

+5

|

+10

|Bonus Ambush Feat, superior vitality

17th|

+12/+7/+2

|

+10

|

+5

|

+10

|Sneak attack +9d6

18th|

+13/+8/+3

|

+11

|

+6

|

+11

|Medical guidance (equal to penalty)

19th|

+14/+9/+4

|

+11

|

+6

|

+11

|Bonus Ambush Feat, sneak attack +10d6
20th|

+15/+10/+5

|

+12

|

+6

|

+12

|Deadly precision +3[/table]

Class Features:
Weapon and Armor Proficiency: Combat medics are proficient will all simple weapons, plus the hand crossbow, rapier, sap, shortbow, and shortsword. In addition, they are proficient with light armor, but not with shields.

Skill Focus (Heal): A combat medic gains Skill Focus (Heal) as a bonus feat at 1st level.

Sneak Attack (Ex): A combat medic can use his medical knowledge to strike a vulnerable opponent’s vital spots for extra damage.

The combat medic’s attack deals extra damage any time her target would be denied a Dexterity bonus to AC (whether the target actually has a Dexterity bonus or not), or when the combat medic flanks his target. This extra damage is 1d6 at 1st level, and it increases by 1d6 every two combat medic levels thereafter. Should the combat medic score a critical hit with a sneak attack, this extra damage is not multiplied.

Ranged attacks can count as sneak attacks only if the target is within 30 feet.

With a sap (blackjack) or an unarmed strike, a combat medic can make a sneak attack that deals nonlethal damage instead of lethal damage. He cannot use a weapon that deals lethal damage to deal nonlethal damage in a sneak attack, not even with the usual -4 penalty.

A combat medic can sneak attack only living creatures with discernible anatomies—undead, constructs, oozes, plants, and incorporeal creatures lack vital areas to attack. Any creature that is immune to critical hits is not vulnerable to sneak attacks. The combat medic must be able to see the target well enough to pick out a vital spot and must be able to reach such a spot. A combat medic cannot sneak attack while striking a creature with concealment or striking the limbs of a creature whose vitals are beyond reach.

Bonus Ambush Feat: At 2nd level, and every 4 levels thereafter, a combat medic man may select any ambush feat (Complete Scoundrel 74) for which he meets the prerequisites.

Medical Expertise (Ex): A combat medic adds ½ his class level (rounded down) as a competence bonus on heal checks.

Deadly Precision (Ex): At 4th level, a combat medic gains a +1 competence bonus on attack rolls made to sneak attack. This bonus increases to +2 at 12th level, and +3 at 20th level.

Patch Up (Ex): At 4th level, a combat medic becomes especially skilled at performing first aid on the battlefield. As a full round action, a combat medic can make a heal check (DC 15), to restore 1d8+1/2 class level of one character’s hp. Using this ability consumes 1 gp worth of medical supplies and can be used once per day per character.

Vitality (Ex): At 6th level, a combat medic gains the ability to improve allies’ physical capability for brief periods. As a full round action, a combat medic can make a heal check (DC 20), to grant a character 1d8+1/2 class level bonus hp. Using this ability consumes 1 gp worth of medical supplies and can be used once per day per character.

Healing Mastery (Ex): At 8th level, a combat medic can take 10 on heal checks, even if rushed or threatened.

Resourceful Treatment (Ex): At 8th level, a combat medic learns how to provide medical treatment with whatever supplies are at hand. He can make heal checks with half the usual gp cost of supplies at no penalty.

Defensive Roll (Ex): 10th level, a combat medic learns how to roll with a potentially lethal blow to take less damage from it than he otherwise would. Once per day, when he would be reduced to 0 or fewer hit points by damage in combat (from a weapon or other blow, not a spell or special ability), the combat medic can attempt to roll with the damage. To use this ability, the combat medic must attempt a Reflex saving throw (DC = damage dealt). If the save succeeds, he takes only half damage from the blow; if it fails, he takes full damage. He must be aware of the attack and able to react to it in order to execute his defensive roll—if he is denied his Dexterity bonus to AC, he can’t use this ability. Since this effect would not normally allow a character to make a Reflex save for half damage, the evasion ability does not apply to the defensive roll, should the combat medic have it.

Medical Guidance (Ex): At 12th level a combat medic becomes quite adept at assisting allies in providing medical care. By accepting a penalty on Heal checks, a combat medic grants a competence bonus on Heal checks to all allies within 30 feet. The penalty can be any number that does not exceed ½ the combat medic class level, and the competence bonus is equal to ½ this penalty (rounded down). Activating this ability is a full-round action and the effect lasts for as long as the combat medic remains conscious and within range.

At 18th level, the competence bonus granted by this ability becomes equal to the penalty accepted by the combat medic.

Crippling Strike (Ex): At 14th level, a combat medic can deliver crippling attacks. An opponent damaged by one of his sneak attacks also takes 2 points of Strength damage. This damage stacks with the effects of ambush feats.

Quick Treatment (Ex): At 14th level, a combat medic learns how to provide medical treatment quickly and efficiently. He can make Heal checks in half the usual time at no penalty.

Superior Vitality (Ex): At 16th level, a combat medic gains the ability to boost allies into peak physical capability for brief periods. As a full round action (after the quick treatment reduction), a combat medic can make a heal check (DC 25), to grant a character a +4 bonus to Strength, Dexterity, or Constitution for 1 minute per class level. Using this ability consumes 1 gp worth of medical supplies (after the resourceful treatment reduction) and can be used once per day per character.

[Kiren]

I have made a split off into what I wanted the surgery rules to be for, and took in alot of the suggestions of jiriku which were very helpful. Ill look at your combat medic class for ideas if you don't mind me doing so.

I think I figured out how to make it fluid, quicker and interesting (and easier to tweak.)

[TabletopNuke]

I think I figured out how to make it fluid, quicker and interesting (and easier to tweak.)

Oh? Do tell.

[Kiren]

Not full passage, just a cut out

Perform Surgery

Ailments are cured by rolling a d20 against the *Vital Damage* of an ailment, adding bonus's from points added to the surgery skill to the final result. A Surgeon cannot perform surgery on himself, a patient cannot move or be moved during a round surgery is occurring. A patient, can continue to use standard actions such as attacking (as long as the required limbs are free to use such attacks) casting or activating an ability.


(First aid is not 100% finished)

Perform First Aid
First aid cures damage from hits by normal attacks. The amount cured by First aid is 1d6 + half the bonus from the first aid skill. A first aid kit is required to heal anyone, performing first aid is a standard action. A surgeon can perform first aid on himself.


Edit: The class has more interesting parts to it, I will post the whole class on the forum.

[Mikka]

Remove the 'vital strike' aka sneak attack, wrap near , if not all the abilities up into 5 levels and you have yourself an interesting prestige class, have low level requirements so it can be entered at level four. Req: heal: 6 ranks. and potentially profession (surgeon?) 4 ranks. and voila hes nice and doesn't hamper a PC too much, and also means that you don't have to make level 20 NPCs to be able to perform abilities that can be mimicked by a level 1 cleric spell or two.

err yes, :)

[TabletopNuke]

Ailments are cured by rolling a d20 against the *Vital Damage* of an ailment, adding bonus's from points added to the surgery skill to the final result. A Surgeon cannot perform surgery on himself, a patient cannot move or be moved during a round surgery is occurring. A patient, can continue to use standard actions such as attacking (as long as the required limbs are free to use such attacks) casting or activating an ability.

You just use your skill ranks, but no other modifiers? Why not just a regular skill check?

How 'bout imposing a -20 penalty when preforming surgery on yourself?

What about making different difficulties of surgery? Minor surgery, say, stitching up a fairly minor injury, could be around DC 15. Moderate surgery, like resetting a bone, DC 20. Major surgery, such as organ transplants, brain surgery, or heart surgery, DC 30.

[Kiren]

The vital damage is basically the Dc (I should really just call it the DC). I was going to have critical hits cause injuries form a chart (a hit to the arm wouldn't break it off, but a vorpal could maybe? I'm working on it still.

Edit: I haven't worked on it much today, but I will incorporate that into it tomorrow.

Edit, Edit: Self surgery I have added as a ability around level 12, but I bumped it up to level 15 at no penalty and added the negative 20 self surgery penalty.

Right now I am working on the critical injury chart, trying to see how I can make injuries affect a character but not ruin the character for life. I'm stuck at how to build the chart. (A breath weapon will cause burns but a sword won't obviously, and if the chart is too unwieldy, this new version will succumb to my to how my previous attempts had ended up)

[Kiren]

I added in the changes to the newer version

Perform Surgery
The surgeon can now perform surgical techniques to cure allies of their problems (unfortunately not a dead problem)

Attempting to perform surgery to cure a ailment is a full round action, to perform surgery the patient must be willing or unable to resist (held down, knocked out, rope).

Ailments are cured by a Surgery skill check against the DC of the injury. A Surgeon can perform surgery on themselves at a -20 penalty, a patient cannot move or be moved during a round surgery is occurring. A patient, can continue to use standard actions such as attacking (as long as the required limbs are free to use such attacks) casting or activating an ability.

A surgeons kit is required to perform surgery.

Surgery can not be performed on constructs, oozes, plants and incorporeal creatures. While it can be performed on undead, their really isn't too much of a point.


This is the rework of the Injuries I am working on, short and simple

Critical Hits/Injuries
Critical hits are a double edged sword, you can make them, and your enemy can too. Unfortunately people get hurt, and those people are usually you. When a critical hit is confirmed roll one d20 on the chart below for an injury.

If the injury rolled is deemed non-applicable to the Dm, another must be rerolled.


I'm thinking if you get hit with the same exact injury on multiple occasions without treatment then more permanent damage like limb loss may occur.

[TabletopNuke]

Alright! This is really coming along.

I don't think there needs to be a level requirement for self surgery. The -20 penalty will do plenty to keep lower level characters from attempting it.

Page 27 of the DMG has a variant for damage to specific areas. You should check it out.

Maybe you should rule that surgery doesn't work on any creatures with no discernible anatomy (amorphous, immune to crits by virtue of no clear anatomy, ect), rather than going by creature type. With the current rules, one could preform surgery on a phasm, an aberration that is anotomically akin to an ooze, and has the amorphous trait.

Also, elementals don't seem like something that one could preform surgery on. Did you leave them out intentionally, or was that a mistake?

Perhaps there should also be a note that surgery can't be preformed on constructs (that's a use of the Craft skill).

I'd have to argue for preforming surgery on plants. One might need special training (a special feat? 5 ranks in Know [Nature]?) but it can be done. Here's a quote from Columbia Encyclopedia:

Tree surgery is the practice of repairing damaged trees to restore their appearance and to arrest disease. Injured or diseased parts are first removed (even small cavities in the bark may harbor injurious fungi and insects), the surfaces are treated with antiseptics and healing aids, and the cavity may be filled with cement or some special material, e.g., composition filler or elastic cement.

Sounds an awful lot like what regular surgeons do to humans, eh?

[Kiren]

Added the limits to what can be operated on (I missed the elementals thanks).
Im going to have to remember to make a tree surgeon prestige class (Although your quote sounds a lot like civil war/pirate era surgery.)

And the Dm's guide info wasn't too much, I will sort out targeting during the weekend.

Edit: Also, I didn't forget about curing disease, for the new surgeon can brew medicines and poisons! Currently nothing is written up for that but that is what weekends are for.

[Kiren]

In the next version, a confirmed crit does normal damage and gets a roll on the body part and injury chart.

Body Part

The table was a mess so I had to take off applicable sources of the damage, and the DC is not made out yet. The only mess now is the penalties for each injury which I should really make more diverse but this was the only idea I had.


Injury Chart

[Kiren]

Here is the body part rolling chart, this one is rolled before the injury chart.

These charts are only rolled on a confirmed crit.



Body Part

Added to the above post.

[TabletopNuke]

I like where this idea is going.

The injury table would be much easier to read if Head, Eyes, Torso, Back, and Leg each got their own column.

I think the "Lucky" option is kind of needless. If they didn't get hit with a crit, that should be enough. If you need something else to fill the space, we could work something else out.

[Kiren]

The lucky collumn is my way of saying I am out of ideas without putting amputation on the list.

Ill get the table fixed up

[TabletopNuke]

The lucky collumn is my way of saying I am out of ideas without putting amputation on the list.

Ill get the table fixed up

You could add in "Compound Fracture". Maybe Compound Fracture + Back results in paralysis.

[Kiren]

I am going to have to make changes to the chart to make things clearer, compound fracture should work, I can also make the chart bigger with more severe forms of a wound.

The body chart seems good but the injury chart needs alot of work still. It is great progress though.

Edit: I need to finish the Surgeon class, although at this point he is turning more combat medic then just surgeon, once I begin to write up the poison and medicine creation.

[un_known]

Is this being continued?

[Nidogg]

I hope so, co I have somthing to add! Anasthestia Rolls!
Cos most problems in sugery are from anasthesia. Only applicaple in a no magic sedation situation.

Roll a Surgery check.
Dc 10+subjects HD +1/2 subject con modifier
This is the Dc to sedate the target. Faliure by 4or less inicates the sedation has clearly not worked and subjest is contios of the fact and may notify the doctor if they dont want to watch.... Faliure by 5 or more indicates partial sedation. The subject wakes halfway through the surgery. The surgeon takes realative penalys because of this.... Faliure by 10 or more indicates an overdose. This causes the patient to take 1d4+every 5 points the surgeon failed the roll (below 10) (e.g surgeon fails anasthesia roll by 17 subject takes 1d4+1) points of con DRAIN. The Drain is reduced to damage if the world has been doing this surgery stuff for a while.

[Kiren]

(Thread Necromancy) I've got something planned, more streamlined and faster.