If a character drops to less than one Health, they immediately go into shock and lose all further actions that round. They must track how much negative Health they receive.
Any healing done must overcome this within the ___ 3 rounds.
During this time, they may receive healing that heals only the negative amount; Once they are at 1 or higher, they will become conscious. They receive a Wound.
Persisting the idea of Gritty Realism there exists several alternative to the simple mechanical outcome of death. Instead of dying, a character may select one of the alternatives:
All damage is converted to Abiding damage. This is damage that does not heal except through normal, natural healing processes. The wound causing this is so damaging and/or traumatic that any use of unnatural healing causes a shock to the system. DC 20 con or it doubles the amount of abiding damage being healed… if that causes death, there are no saves or checks – death is instant and permanent.