((I just gave it a quick check and it's a bit messy about it. It says that at 0 HP or below your character is unconscious and dying. However, if you manage to roll a 20 or more, you spend a healing surge and regardless at how much HP you were [Like if you were at say -1] you'd go back to 0 HP at which state you are not dying, but merely conscious and prone.
This begs the question whether you need to expend a healing surge to be at 0 HP and not be dying or just being at 0 HP is enough.
After a further bit of reading, it also reads another thing that makes it even harder to understand. It says that as soon as you have a total hitpoint that's higher [doesn't say equal] than 0, you become conscious and prone.
If I was a DM, however, the way I'd interpret these rules is that if you're at 0 HP, you're dying and need a 20+ roll for a normal healing surge which would be used to stop you from dying [after which you'd need another one to increase your health beyond 0 HP. But even if you don't you'd be conscious after the first surge. However if you're in the negative state [-1 for example] then if you got a 20+, you'd be at 0 HP but conscious and prone, unlike the previous example.
In the end, it depends on the DM and interpretation of a situation. I like to think that the shock of Alexander breaking his arm is what made him slip into unconsciousness.))
((Here's the easy bit:
You're knocked to 0hp, meaning you have no more energy left to fight. You need to get a 20 or higher (you get a + to death saves with feats, class, race, gear, etc.) to will yourself to get back up and fight. You then spend a healing surge (it still works if you have 0 if I recall, but only works once per encounter) and regain your surge value as if your HP total was 0. So say Isbat, who was at -8hp gains lay on hands, he gains 12hp. He doesn't go to 4hp, but he instead goes up to 12, as if his HP total was 0. -hp always is a mark of how much damage you take after being knocked out. Its pretty much the equivalent of slitting their wrist or throat to finish them off, or hacking at them to make sure they're dead.
Once you regain that surge, you are prone but awake/alive. Why? You fell over when you got knocked out (unless you somehow manage to stand when you die, but you're knocked out and probably took a hit that will push you over).
Here's an example, as Death9980 will remember from our campaign.
Olon, the artificer, was knocked out by Dar Jeeki, the monk after being pummeled to -11 (daily powers suck) and then taking another 6 damage from flurry of blows for good measure. Olon is at -17 and is dying. He rolls a d20 on his death save and rolls a 19. He has a +2 to death saves from his armor (haunted leather) and even though he hasn't failed his death saves today, he would gain a +5 to death saves and succeed on a 15 or higher. He gets back up for having 21 (higher then 20) and heals his surge value back up to 16hp left instead of not being able to get back up since his surge value is lower then the damage he has sustained when down.))
((Oh hey, you mentioned Alexander has to make a death save - if he's exactly at 0 hp, shouldn't he be unconscious but not dying? I thought dying only happened at -1 through -9, butt that might just be my experience with the old rules speaking.))
((He's dying. You're thinking of stabilizing which I believe send him to 0hp but no longer has to make death saves))
((Dunno what you expect me to do, really.))
Ready an Action: Acid Orb on the creature the instant it emerges.
Ready Curse of the Dark Dream, and pull it straight up.
Move to stand beside the pillar, take a health potion, and ready Erupting Flare.
Thoradin goes up to Cromwell and (?) administers first aid, giving Cromwell (8)hp
Move to Isbat, use Lay on Hands on Isbat, and drink a potion for Karl
Move to Isbat, use Lay on Hands on Isbat, and drink a potion for Karl
Thanks for the help my friend
(and when it gets to me)
standard: second wind
minor: drink a heath potion
action point: ready greenflame blade for the giant worm
Karl regains (10)hp from his potion and heals Isbat for (12)hp. Isbat second winds and downs a potion himself, healing him for a total of (22)hp extra. You are at 36hp. You ready your blade as you all feel the tremor rising in intensity.
You all feel the calm before the storm; if this fails, surely some of you will die. Karl swears he sees the image of a woman at the corner of his eye, but its gone as you hear the great blast as the wurm rises from the earth! (4+5) Weston's acid orb misses, but manages to dislodge his dagger! (
CRIT) Cromwell's power explodes out of his rod, psychic energy bursting forth and hurling the beast out of the ground! Though the best takes no fall damage, Cromwell deals (10+10+10+5+2) psychic damage! (19+7) Nadarr's blast of fire envelops the beast, turning Cromwell's dark and fell aura surrounding the beast and turning the flames red with purple! Your flames deal (2+6+7) fire damage! Isbat swings his blade as the flames envelop the beast! (14+11) Your flames lick the beast, creating a giant inferno with Nadarr's burning hands. The flames turn a strange, bright maroon color! You deal (7+6) fire damage!
The beast's attack still goes off, but in a reduced strength! (?) (?) (?) (?) (?) (?) He misses everyone but deals (18) damage to everyone! ((wow that was a lot for half damage on a miss)) Weston, Nadarr and Cromwell collapse, but they're safe, as the beast dies almost immediatley after its barrage of stones fly out and pummel the party. Karl, Thoradin and Isbat stand firm as the beast roars and then falls.
Cotl, the Great Burrower, The Forgotten Beast, The Feathered Serpent, has finally been defeated.
Everyone gains 420xp. Karl gains an additional 180xp for his well played attack. Everyone who wasn't level 4 (Weston, Cromwell, Alexander, Thoradin) is now level 4. ((I require two ability scores to increase by +1 and then a feat))
Thoradin administers first aid to the fallen party members, except for Alexander, who is still at the bottom of the hole. Thoradin asks if anyone has a rope or chain longer then 50ft to see if Alexander is alright. Nadarr is out of healing surges and is stuck at 8hp. Weston shares the same fate and is stuck at 18hp. Everyone but Cromwell and Thoradin gain a milestone! (one additonal action point, etc.)
Alexander makes a death save (10) you succeed and still live but are dying.