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All creatures and objects have Hit Points (HP). Your maximum Hit Point value represents your health, wherewithal, and heroic drive when you are in good health and rested. Your maximum Hit Points include the Hit Points you gain at 1st level from your ancestry and class, those you gain at higher levels from your class, and any you gain from other sources (like the Toughness general feat). When you take damage, you reduce your current Hit Points by a number equal to the damage dealt. 

Some spells, items, and other effects, as well as simply resting, can heal living or undead creatures. When you are healed, you regain Hit Points equal to the amount healed, up to your maximum Hit Points.

Knocked Out and Dying

Creatures cannot be reduced to fewer than 0 Hit Points. When most creatures reach 0 Hit Points, they die and are removed from play unless the attack was nonlethal, in which case they are instead knocked out for a significant amount of time (usually 1 minute or more). When undead and construct creatures reach 0 Hit Points, they are destroyed. 

Player characters, their companions, and other significant characters and creatures don't automatically die when they reach 0 Hit Points. Instead, they are knocked out and are at risk of death. At the GM's discretion, villains, powerful monsters, special NPCs, and enemies with special abilities that are likely to bring them back to the fight (like ferocity, regeneration, or healing magic) can use these rules as well. 

As a player character, when you are reduced to 0 Hit Points, you're knocked out with the following effects: 

• You immediately move your initiative position to right before the current turn.
  
• You gain the dying 1 condition. If the effect that knocked you out was a critical success from the attacker or the result of your critical failure, you gain the dying 2 condition instead. If you have the wounded condition, increase your dying value by an amount equal to your wounded value. If the damage was dealt by a nonlethal attack or nonlethal effect, you don't gain the dying condition; you are instead unconscious with 0 Hit Points.
  

Taking Damage while Dying

If you take damage while you already have the dying condition, increase your dying condition value by 1, or by 2 if the damage came from an attacker's critical hit or your own critical failure. If you have the wounded condition, remember to add the value of your wounded condition to your dying value. 

Recovery Checks

When you're dying, at the start of each of your turns, you must attempt a flat check with a DC equal to 10 + your current dying value to see if you get better or worse. This is called a recovery check. The effects of this check are as follows.

Critical Success Your dying value is reduced by 2.
Success Your dying value is reduced by 1.
Failure Your dying value increases by 1.
Critical Failure Your dying value increases by 2.

Conditions Related to Death and Dying

To understand the rules for getting knocked out and how dying works in the game, you'll need some more information on the conditions used in those rules. Presented below are the rules for the dying, unconscious, wounded, and doomed conditions. 

Dying

You are bleeding out or otherwise at death's door. While you have this condition, you are unconscious. Dying always includes a value. If this value ever reaches dying 4, you die. If you're dying, you must attempt a recovery check at the start of your turn each round to determine whether you get better or worse. 

If you lose the dying condition by succeeding at a recovery check and are still at 0 Hit Points, you remain unconscious, but you can wake up. You lose the dying condition automatically and wake up if you ever have 1 Hit Point or more. Anytime you lose the dying condition, you gain the wounded 1 condition, or increase your wounded value by 1 if you already have that condition. 

Unconscious

You're sleeping, or you've been knocked out. You can't act. You take a –4 status penalty to AC, Perception, and Reflex saves, and you have the blinded and flat-footed conditions. When you gain this condition, you fall prone and drop items you are wielding or holding unless the effect states otherwise or the GM determines you're in a position in which you wouldn't.

If you're unconscious because you're dying, you can't wake up as long as you have 0 Hit Points. If you're restored to 1 Hit Point or more via healing, you lose the dying and unconscious conditions and can act normally on your next turn.

If you are unconscious and at 0 Hit Points, but not dying, you naturally return to 1 Hit Point and awaken after sufficient time passes. The GM determines how long you remain unconscious, from a minimum of 10 minutes to several hours. If you receive healing during this time, you lose the unconscious condition and can act normally on your next turn.

If you're unconscious and have more than 1 Hit Point (typically because you are asleep or unconscious due to an effect), you wake up in one of the following ways. Each causes you to lose the unconscious condition.

• You take damage, provided the damage doesn't reduce you to 0 Hit Points. (If the damage reduces you to 0 Hit Points, you remain unconscious and gain the dying condition as normal.)
  
• You receive healing, other than the natural healing you get from resting.
  
• Someone nudges or shakes you awake using an Interact action.
  
• Loud noise is being made around you—though this isn't automatic. At the start of your turn, you automatically attempt a Perception check against the noise's DC (or the lowest DC if there is more than one noise), waking up if you succeed. This is often DC 5 for a battle, but if creatures are attempting to stay quiet around you, this Perception check uses their Stealth DC. Some magical effects make you sleep so deeply that they don't allow you to attempt this Perception check.
  
• If you are simply asleep, the GM decides you wake up either because you have had a restful night's sleep or something disrupted that rest. 
  

Wounded

You have been seriously injured during a fight. Anytime you lose the dying condition, you become wounded 1 if you didn't already have the wounded condition. If you already have the wounded condition, your wounded condition value instead increases by 1. If you gain the dying condition while wounded, increase the dying condition's value by your wounded value. The wounded condition ends if someone successfully restores Hit Points to you with Treat Wounds, or if you are restored to full Hit Points and rest for 10 minutes.

Doomed

Your life is ebbing away, bringing you ever closer to death. Some powerful spells and evil creatures can inflict the doomed condition on you. Doomed always includes a value. The maximum dying value at which you die is reduced by your doomed value. For example, if you were doomed 1, you would die upon reaching dying 3 instead of dying 4. If your maximum dying value is ever reduced to 0, you instantly die. When you die, you're no longer doomed.

Your doomed value decreases by 1 each time you get a full night's rest.

Death

After you die, you can't act or be affected by spells that target creatures (unless they specifically target dead creatures), and for all other purposes you are an object. When you die, you are reduced to 0 Hit Points if you had a different amount, and you can't be brought above 0 Hit Points as long as you remain dead. Some magic can bring creatures back to life, such as the resurrect ritual or the raise dead spell.

Heroic Recovery

If you have at least 1 Hero Point, you can spend all of your remaining Hero Points at the start of your turn or when your dying value would increase. You lose the dying condition entirely and stabilize with 0 Hit Points and become conscious. You don't gain the wounded condition or increase its value from losing the dying condition in this way, but if you already had that condition, you don't lose it or decrease its value.

Death Effects and Instant Death

Some spells and abilities can kill you immediately or bring you closer to death without needing to reduce you to 0 Hit Points first. These abilities have the death trait and usually involve negative energy, the antithesis of life. If you are reduced to 0 Hit Points by a death effect, you are slain instantly without needing to reach dying 4. If an effect states it kills you outright, you die without having to reach dying 4 and without being reduced to 0 Hit Points. 

Massive Damage

You die instantly if you ever take damage equal to or greater than double your maximum Hit Points in one blow.

Temporary Hit Points

Some spells or abilities give you temporary Hit Points. Track these separately from your current and maximum Hit Points; when you take damage, reduce your temporary Hit Points first. Most temporary Hit Points last for a limited duration. You can't regain lost temporary Hit Points through healing, but you can gain more via other abilities. You can have temporary Hit Points from only one source at a time. If you gain temporary Hit Points when you already have some, choose whether to keep the amount you already have and their corresponding duration or to gain the new temporary Hit Points and their duration.

Fast Healing and Regeneration

Some abilities grant fast healing, and some creatures have regeneration. A creature with either ability regains the listed amount of Hit Points each round at the beginning of its turn. A creature with regeneration has additional benefits. Its dying condition never increases beyond dying 3 as long as its regeneration is active. However, if it takes damage of a type listed in the regeneration entry, its regeneration deactivates until the end of its next turn, including against the triggering damage.

Items and Hit Points

Items have Hit Points like creatures, but the rules for damaging them are different. An item has a Hardness statistic that reduces damage the item takes by that amount. The item then takes any damage left over. If an item is reduced to 0 HP, it's destroyed. An item also has a Broken Threshold. If its HP are reduced to this amount or lower, it's broken, meaning it can't be used for its normal function and it doesn't grant bonuses. Damaging an unattended item usually requires attacking it directly, and can be difficult due to that item's Hardness and immunities. You usually can't attack an attended object (one on a creature's person).