In the Iconic Adventuring System, both physical and mental trauma, take the form of either wound or stress cards. When you gain a wound card, oftentimes you place the card face-up in the discard pile of your character deck (known as the fatigue pile). While it remains in your character deck, it acts as adrenaline, allowing you to lose more fatigue than normal and can prevent further stress or even additional wounds.

However, once drawn into your hand, both stress and wound cards make tasks difficult to accomplish, reducing your hand size. While you forsake (remove from the game) stress cards at the end of your turn, wound cards remain until dealt with through medicine, natural healing, or miracles. Although, medicine in a medieval fantasy setting has limits, and often binding a wound will allow you to discard it back into your character deck, but not forsake it. This represents an old wound reopening, a festering infection, or some other ailment caused by the injury.

Once your hand is full of wound cards, you collapse and begin dying, discarding a card from the top of your character deck each turn. If it is a willpower card, you regain consciousness and can discard one wound card into your fatigue pile. If the revealed card is a wound card, you breathed your last breath.

Non-playing characters (NPCs) do not have a character deck. Not as hardy as stalwart adventurers, one wound is sufficient to vanquish a dreaded foe – called a dramatic end. It is up to the vanquisher (you the player) whether you subdue your opponent, run it through, or have them flee to recount their defeat by your hand. However, do not fool yourself that a dragon or some other vile beast is a simple conquest having just one wound. While you may survive an encounter with these horrid foes, even at the start of your adventuring career, vanquishing such creatures is an undertaking of epic proportions.

However, with just one wound, Game Masters no longer need to keep track of hit points, or the like, and can instead focus on the titanic battle at hand, weaving a terrific tale for all to remember in years to come.