Radiation Poisoning

Radiation Poisoning is a new condition that is a constant danger in the post-nuclear world. What begins with symptoms of nausea leads into headaches, fever, dizziness, weakness, and ultimately hair loss, high infection risk, poor natural healing, and other serious symptoms.

Whenever a creature is exposed to a source of radiation, they may gain a level of radiation poisoning.

If a creature already suffering from radiation poisoning falls victim to another effect or fails a saving throw that results in radiation poisoning, its current level of the radiation poisoning condition increases by the amount specified in the effect’s description. A creature suffers the effect of its current level of radiation poisoning as well as all lower levels.

Level Effect
1 You are poisoned.
2 You gain a level of exhaustion.
3 You gain a level of exhaustion.
4 You gain a level of exhaustion.
5 You gain a level of exhaustion. Halve any hit points or temporary hit points you receive from natural healing or curative items and effects.
6 Death.

Many effects cause Radiation Poisoning instantly. Others, such as consuming irradiated food and drink, have a delayed impact but become immediately serious after a single saving throw, even if that saving throw is not made immediately.

Radiation Damage

Many creatures and certain environmental hazards can deal hit point damage of the radiation type. A character is not required to make a saving throw every time they suffer radiation damage. Instead, every time the character loses hit points from radiation damage it increases their chances of gaining Radiation Poisoning.

Rad Resist

All creatures have a Rad Resist score equal to 5 + their Constitution saving throw bonus.

When a character attains a new level, they automatically increase their Rad Resist score by +1. It is also possible to increase Rad Resist by selecting the Rad Resistance feat.

Creatures without character levels add their CR -1 (to a minimum of 0) to their Rad Resist. For instance, a CR 7 Raider Boss has a Rad Resist of 15 (5 + 4 Con + (7-1)).

Geiger Counters

Each time a creature suffers one or more points of radiation damage, the Game Master gives that creature’s player a token known as a geiger counter. If the damage exceeds the creature’s Rad Resist, they are given two geiger counters.

You can use any kind of token to represent geiger counters, including poker chips, cards, and so on. Geiger Counters are also included in the Fifth Edition Fallout Counters Pack. You can download the pack from the Fifth Edition Fallout page on the Spilled Ale Studios blog. If you prefer not to use counters at all, players can also simply keep tallies. Keeping tallies is also likely the best option for the GM when it comes to NPCs, regardless of the method used by players.

When a creature with one or more geiger counters takes a short rest, they make a Constitution saving throw with a DC equal to 8 + the total geiger counters they’ve collected. On a failed saving throw, they gain a level of radiation sickness.

Variant: Rad Boxes

Rad Boxes are an alternative, simplified way of determining Radiation Sickness from radiation damage. With this option in play a creature has a pair of “rad boxes” which are checked off as it takes damage, rather than keeping track of geiger counters.

  • When a creature takes radiation damage less than their Rad Resist score, check the first of the two rad boxes. Should this box be the only one marked when the creature next takes a short rest, it must make a DC 10 Constitution saving throw against radiation sickness.
  • When the creature takes radiation damage equal to or exceeding their Rad Resist score, check the second rad box. Should this box be the only one marked when the creature next takes a short rest, it must make a DC 13 Constitution saving throw against radiation sickness.
  • Should both rad boxes be marked when the creature next takes a short rest, it must make a DC 15 Constitution saving throw against radiation sickness.

Geiger Counters Vs. Rad Boxes Comparison

When using geiger counters, the difficulty of the Constitution saving throw DC builds up gradually with each instance of damage, and can eventually exceed the maximum DC possible when using the Rad Box rule. With the Rad Box rule a lucky creature might endure many attacks while only checking one box, but on the other hand the DC might jump up considerably with only a couple of attacks. Though simpler to adjudicate, the Rad Box rule will often end up being harsher than geiger counters, particularly for creatures with lower Rad Resist scores.
Therefore, this option is primarily recommended for NPC creatures. You can use it for PCs too, just be aware it makes the wasteland that little bit more dangerous for them.

Fallout is the sole intellectual property of Bethesda Softworks. This is purely a fan work. Rules presented work with D&D 5e. Text and game mechanics presented in this wiki are not Open Game Content and should not be reproduced or repackaged in any way.