Damage Types. There are four damage types: Physical, Energy, Fire, and Radiation.

Radiation
is a special case that does not affect your HP directly but causes serious status effects.

● Physical Damage comes from damage caused by impacts, piercing, slashing, falling,
and other traumatic events.
● Energy Damage comes from electromagnetic energy and thermal energy being
transferred to the tissues of the target. This causes burns, vibrations, and boiling that
destroys the body of the target.
● Fire Damage is specifically from chemical oxidation reactions and notably different from
energy in its need for proximity and ability to spread. While the burns from energy and
fire are similar, the ability to resist them is very different so they are classed differently.
● Radiation is a special case detailed below. It comes from charged particles, and very
high energy EM and while it can cause warming it usually affects it target in more
indiseous mechanisms causing your body to breakdown and mutations such as cancer,
or a new arm, to form.

Resistances. In addition to AC which represents your ability to completely evade taking

damage serious enough to affect your HP, some creatures, armor, and perks have Resistance.
Resistance simply reduces each instance of damage by a specific amount. For example, if you
have 5 Fire resistance, you subtract 5 damage from any given instance of fire damage, usually
totalled over a round as something like 1d6 fire damage. Radiation and its resistance has some
special characteristic described below.

Diseases. The wasteland has many diseases, some from before the Great War, many from
after. Just like brahmin and mutants, viruses and bacteria also mutated in the wasteland to form
new blights on the remnants of humanity. If it is known, a disease can be identified by a
successful medicine check. Common diseases require no check, and first-of-its-kind ones may
require several checks to figure out. The common cold, and yearly flu are still the most common,
however, there have come about even more exotic diseases that can cause mutations, or even
enslave their carrier.

Survival. For some, this is all that is left. The struggle to survive in the wasteland has improved
in some places, such as the NCR. But in most of the former United States every day is still a
struggle. You may be thinking of radscorpions, and yao gai, but as ever the largest threat is the
elements. Hot and cold, dry and wet, lack of food and shelter kills more people than any
deathclaws. In your travels you must remember to eat, and drink, and to keep warm or cool. Get
sleep, and avoid too much radiation. If you fail in this you will risk serious conditions that will
make survival even more difficult. Exhaustion is the most common risk of lack of food, sleep,
and water, but other effects as defined by the DM can also befall you.

Radiation. The slow killer. Death by radiation takes time, but you will wish it hadn’t. Taking
Radiation Damage increases your rads absorbed. It does not decrease your HP directly but will
cause radiation sickness shown below. Your total rads absorbed is cumulative and can only be
reduced with rad-away, some items and perks, and well trained doctors with the right
technology. As your rads increases, you suffer the following effects:

Radiation Level Description Effects

0-100 No effect

101-200 Slightly Nauseous -10% Max HP

201-300 Always tired Unable to use reactions

301-400 Vomiting -20% Max HP

401-500 Hair Falling Out Exhausted, level 1

501-600 -30% Max HP

601-700 Bleeding all over Exhausted, level 2

701-800 -40% Max HP

801-900 Skin falling off Exhausted, level 3

901-1000 -50% Max HP

1001+ Death Or Worse

The exhaustion levels cannot be removed by anything but reducing your rads. The HP reduction
is total at that point.

Removing Radiation. Luckily for those of the wasteland, the prewar USA stockpiled huge
quantities of rad-x and radaway in anticipation of the war so these can be found across the
wasteland. Some technology and perks may also remove or mitigate radiation. Not to mention
that some races have natural resistances.

Rad Absorption. Radiation is usually either dealt instantaneously (20 rads from an x-ray), or
over time (5 rads/round). In either case, resistance removes that amount of radiation from each
instance. Because rads tend to be dealt over time, the DM will often use the combat rounds
system to get the granularity of radiation even if there is no combat. Most contaminated food
gives an instant radiation dose, as does drinking. Usually these are low, but sometimes they can
be quite high, even affecting normally resistant creatures.