View Full Version : death knight blood tanking - advice

11-16-2009, 12:59 AM
Hello Tankspot community,

Short intro on me. Im mikee from azuremyst and i have played a death knight since wotlk (of course), however before my death knight i was a warrior tank in classic and i was a resto druid in tbc. Since Wotlk my main focus has ben on dps, and i do extremely well, however in my guild we are in need of a good dk tank. I have played around with tanking as a death knight before and tanked ulduar when it was released due to a lack of tanks at the time. With icecrown in my sights I want to make sure im ready with gear, specc, glyphs, rotation and knowledge. You name it I want to know it and be good at it, within the confines of death knight tanking. So onward:

WoW Amoury - Death Knight Mikee - EU Azuremyst (http://eu.wowarmory.com/character-sheet.xml?r=Azuremyst&n=Mikee)

So there I am, now to explain a few things and ask for advice on a few other things. After testing each specc I really felt most confidence in the blood tree with such a strong balance of surivial and TPS (25man raiding in mind). In unholy i feel there is alot of potienal for surivial in ICC however I was not producing the TPS. In frost I felt it was nice but not amazing, I also tried DW and found it to be inferior personally though i see potienal again for it in ICC. Are these things ive experienced to be true, is blood the better specc currently and how will it shape up in ICC?

The glyphs im using at the moment are disease, death strike and vamp blood. I personally find glyph of disease a must, i get so much more tps refreshing disease rather then reapplying them and i tend to save rune tap for a 'ah crap disease almost out and runes on cd' because i havent perfected my rotation just yet, which i need to fix before ICC with the 4 set bonus of tier10. I do not have the t9 4 set bonus yet but i feel once i do have it (in 2-3 weeks from now) the vamp blood glyph will be rather OP, 15 seconds per every 50 seconds with playing with cd's or always there for a boss special. Glyph of death strike im not completely sure about. Im torn between the death strike and the runestrike glyphs, that glyph slot mainly being focus to surivial. I do carry glyphs around with me aswell and it might be better that i just reglyph for certain fights, either for surivial or tps each time however i think the utility, survival and tps glyph combo is pretty solid. Not sure if im right in thinking this and would love feedback about glyphs please.

Next up my gear and stats. I only swapped into tank main specc 3 days ago (when writing this post). The last time I worked on my tank gear was ulduar release, but havet tanked for a few months now so as you can imgaine my gear is not the best yet. My plan for emblem usage is to get the ring next, followed by the trinket and then the tier helm and chest. The BiS list I made for mysef is as follows (BiS first, currently available second):

Head- Tier 9 258 / 245
Neck- Jaxx 10man hc
Shoulders- Tier 9
Back- Tribute 25man / 10man
Chest- Tier 9 258 / 245
Wrist- Beast 10man hc (BiS attained)
Hands- Tier 9 258 / 245
Waist- Champs 25man hc / normal
Legs- Jaxx 25man hc
Feet- Twins 10man hc (BiS attained)
Ring1- Twins 10man hc
Ring2- Emblem ring
Trinket1- Champs 25man hc / normal
Trinket2- Emblem trinket
Weapon- Tribute 25man sword

Right now I am over the hit cap, though it will be fixed once I replace my belt which I plan to do so as soon as it drops.

Reasoning behind some of the things. First of all the jaxx 25man legs expertise is awesome and I need it, currently really lacking in expertise, which is why I choose that as the off tier item. The ring selection is down to the amour on the rings, the amour combined with the hp and aviodance stats on both rings i feel are better then all other rings for total surivial added. I choose the amour trinket from emblems as that amour with the avoidance cd i think is the best thing out there for dk's, but i dont know if im right. I think the itemization of the 10man grand crusader neck (jaxx), bracers (beasts) and boots (twins) are much better then the 25man counter parts for me to have the caps with good avoidance and hp pool. The weapon choice is because of 2 aspects, it has hit and it is a agility weapon. I think agility weapons are best suited for dk tanks due to it giving us dodge, amour and also small tps increase (crit). Now i dont know if im right in all of this and would really be thankful for some feedback.

On my realm there is no death knight tank of any standard to talk to. 80% of the server have played for less then a year. I am really seeking a good discussion with peaple who know more then me and are just plain better to learn from. All tips, corrections and advice are greatly welcomed. I just want to work on my skill :)

Also sorry for not providing links to my gear list, I dont actually know how to make the item to be linked in such a way so when you hover you mouse over the information of the item pops up as a small window.

Thaks for reading and for any response.

11-16-2009, 03:14 AM
hey ya, im the MT for the guild im in n im a blood dk tank, heres my armory link, The World of Warcraft Armory (http://eu.wowarmory.com/character-sheet.xml?r=Arathor&n=Ltseb), the website i used for my rotation is Tanking | Skeleton Jack (http://www.skeletonjack.com/category/tanking/) i used the spec from here aswell but i added bloodworms which heal for about 250-300 each worm per second, ur specs not to bad but i would take points off subversion, sent of the blood, spell deflection and hysteria, other than spell defeltion there better suited for dps spec not tanking, i would put the points on improved run tap, would not believe how usefull it can be in a pinch heals me for like 10k-12k hp, even more with vampiric blood activated, like i sed bloodworms for the extra bit of healing to urself n improved blood pres because all healing done to u is increased by 2%, might not sound alot but it helps, and i would change ur glyph of the ghoul for glyph of vampiric blood, n get the black heart from ToC normal, just find ppl to help u farm it, its easyish to get n its one of the best tanking trinkets iv seen, and thats it, the rest is fine, hope this helps

also to get the link thing ur on about so when u hover over the item it brings it up, use Wowhead: You haven't found the secret title yet. (http://www.wowhead.com), find the item u want then just copy n paste the link Koltira's Chestguard of Triumph - Item - World of Warcraft (http://www.wowhead.com/?item=48557)

11-16-2009, 07:33 AM
Thank you for the reply Ltseb, would would like to go over a few points of what you said to deepen my own understanding. Start from the first thing you said and working through in order, it will seem like i disagree but its just how I learn. Hope you dont find it annoying ;)

Bloodworms: In regards to blood worms. They heal for 250-300 per second before taking into account vamp blood or IBP. My guilds current level of progression is working on Algalon realm first, Yogg+1 and Champs HC (all 25man ofc). When tanking gormak on hc he hits incredbily hard, and when tanking algalon he hits with incredible speed. I dont know what their dps is but i would assume its over 30,000 dps. I tested out the worms and did see there use at all apart from overhealing. The raid healers were working very hard keeping me topped and a 300 heal wasnt making a difference, in 5 man heroics I saw it being kind of good. I just feel that maybe the 3 points are better spent in gaining more tps or surivial somewhere, but I might be under estimating the bloodworms. Could you go inot this futher?

Subversion: I put the 3 points in here for the threat generation. HS is my main source of TPS and 9% ore crit just increases the TPS nicely. At the moment i am managing 7-9k TPS which i really need to get higher as its pretty much the same as the top dps'ers of my guild who are at 8-9k dps. The paladin tanks of the guild are able to do 10k average TPS and its my aim to hit that. I could replace this though with something else gave better TPS results i guess.

Scent of Blood: When i first read the tooltip I didnt think much of this and didnt even test it out. I then spoke to someone on the Silvermoon realm who said he thought the same way until someone pushed him into testing it out and now he swears by it. So i thought whats the worst that could happen and gave it a test. He was right. It is so awesome for tanking. My rotation is very runic power heavy with spamming runic strikes, death coils and AMS / IBF usage that it easy to run dry but by having just 2 points in this you gain tons more RP. Having a single point in I get it now and then but its not always up, having 2 points its up 80% of the time and i see it stacking to 3 now and then, having 3 points is overkill and I cant swing fast enough to use it up the charges. I really think this is a must for tanks, blood at least, my lifes better.

Spell Deflection: When looking at it on paper to me it looks like it makes sense, able to parry spells yea that sounds awesome. I can see many oppotunties for it to happen aswell, like thorim HM, hodir HM, mimiron HM, Beasts worms and icehowl, Jaxx, Champs and Twins and will be many oppotunties from what I see of ICC on ptr's. Unholy has 6% base reduction, improved AMS and also ANZ. Frost has improved frost presence to reduce % of all. Blood has parry chance to reduce by 45%, which for me is 21% chance in raids. I just dont see the down side of this, could you go into more depth on why you say a tank shouldnt have this please.

Hysteria: This is purely to increase raid dps. I cast this on the top melee dps'er. Its a mini heroism every 2 mins and he / she will love you so much you will not believe. As a melee dps'er i can tell you this is as good as sex!! Ok maybe not as good as sex but its pretty dam close. You should have this as a blood tank combined with a macro like:

/cast [target='melee dps name here']hysteria
/whisper 'melee dps name' You have Hysteria! ZOMG GOGO DEEEPS!!!!

Yea this is will give another 2-4k dps for the raid by buffing the top dps'er. What I tend to do aswell is buff the top rogue dps with it just before he does tricks to give me even more threat when he does tricks.

Improved Rune Tap: I use to have this in my specc and i found times when it was awesome like on thorim HM or when I solo MC or heroics. However i found timing my rotation to have that blood rune ready really tricky focusing on my health to pop it when needed a large distraction causing bad loss of threat, which is my own personal issue. 80% of the times I used it, it was just a over heal as the healers got there first. I can currently understand its use but I felt I over estimated it when I took it and it didnt give the goods where as the TPS gained with those 4 points somewhere else is a real improvement. However yes this is good and i think I will test it out some more.

Glyphs: Amoury didnt upgrade the glyphs from my PvP ones. I wrote a section about the glyphs i use and why in my first post. My glyphs currently are vamp blood, death strike and disease. I am thinking about replacing death strike with rune strike glyph.

Trinkets: My guild will soon have faction champs hc down and I will get the first of the HP trinkets from that, and next tuesday I will get the amour trinket from the emblem vendor. On paper doing the number crunching both of these are better then all other trinkets for surivial but maybe my data is incorrect. I also have the onxyia head hand in trinket for avoidance. I use to use my old DPS trinkets to increase my TPS, but I have stopped that now.

Gems and Enchant: I forgot to talk about my gems and enchants. Currently im mostly gemmed 30 stam. I think I should resocket my shoulders and gloves to activate the bonus with 10 dodge 15 stam. I think a total of 10 dodge and 21 stam gives better surivial numbers then justpurely 30 stam. Is this correct? And with enchant its mostly just stamina with amour anywhere possible. My chest has the defense enchant for now to stay capped and will be replaced when possible. Im not sure if 275 health or 10 stats is best for the chest, im guessing 10 stats will be overall better with the increase it gives to hp, dodge, amour, parry and even tps?

Thanks for the feedback and I really look forward to your replies and more feedback.

11-16-2009, 08:51 AM
O.o I'm also from Azuremyst.

Anyway, have you read Satorri's thread(s) on the Theorycrafting forum? That, the articles at pwnwear.com and the EJ forums are my usual sources of information on DK tanking.

Sorry, can't help you much with Blood tanking since i only have experience with Frost tanking.

11-16-2009, 09:22 AM
u do make some very good points, i might consider tring some of em out myself.

Bloodworms: you get 250-300hp per worm per second, you get 4 worms so it works out tobe about 1000-1200hp per second, thats without any buffs, dont think they apply to your worms anyway, they can be hit by mobs but they dont generate much aggro if any at all, so shouldn't get hit unless hit by AoE's, helps for suvival, not nessasy but it helps.

Subversion: i never have a problem being out tps so iv never considered this, if you have a problem with threat then i guess this would be ok, i use Rune Strike its the best theat move a DK has, i use it every chance i get, and im currently under hit capped i only have 3% hit and like i sed i still dont have a problem with threat, locks n hunters get close but still not a problem, pally tanks are just aggro whores lol its unfair how much threat they generate compaired to DKs, our threat generation could be doin with bein nerffed abit but ant gona happen :( i used Rawr and put my gems, enchants n gear or simular gear cuz some are class pacific, apart from my weap, i left them how they were on a pally tank in my guild n the threat neally doubled its so unfair lol i dont think you will ever be able to keep up with pallys unless u have better gear than them.

Scent of Blood: again if you have trouble with threat or like you say your rotation is RP heavy then i guess this is ok, in the rotation i use i only ever spam RS cuz it hits along side with ur rotation so you dont need to squeeze it in anywhere, well i think so anyway, i might give this 1 ago myself tho.

Spell Deflection: i use anti magic shell when ever i need it, n my healers dont have any prob out healin any magic that hits me, you mostly get hit by physical attacks so just never seen any point in this, for pvp its great n like you say the faction camps, but i just never needed it. and i think ur healers are better than mine n if my healers can heal me through it dont think urs will have a problem with it.

Hysteria: iv never used this, never really even looked at it, didnt even know u could cast it on other ppl lol so i cant really say much on this 1, for 1 point tho i think i might give it ago myself, does it stack with blood lust?

Improved Rune Tap: i have trouble gettin this in my rotation some times aswell but i save blood tap so i just use that then rune tap or any other CDs that i got on hand, i only ever use it in a pinch, n most of the time i get there be for the healers do, n in some cases its saved my life, like in ignis the furnace master in uld, when were doin the speed run they have been times where my heath has droped below 100hp i use it then get hit again b4 the healers got there heals in, if i didnt have it i would of died for sure lol the way i have my screen set up i have my target and my target's target in the middle of my screen n cuz its usally me thats bein targeted i dont have to keep lookin up in the corner every second.

its all about what you need the most, where as you need threat so spending ur points on giving u more threat is the way to go, where as i dont have a problem with threat, its healing i some times have a problems with so iv gone for things that gives me heath n makes it easier for the healers healing me, the healers in my guild are good, but arent the best geared atm, so every bit helps. try the rotation from the website i posted b4, give it ago, works great for me. heals me n generates great threat.

iv got to go out now so i ant got time to go thru the rest with ya atm, but will do l8a

11-16-2009, 10:04 AM

Bloodworms; I dont remember it working like that. I thought they heal for like 20-30 each not 250-300 each. But even the number is based on chance and on mimiron firefighter fight they die none stop. Same with thorim HM and such. However I will try them out again after my raid tonight to test again.

Subversion: I of course use rune strike none stop however I still work extremely hard to stay on stop, at least for the first 10% of the boss fight. TPS increase is really important because the dps'ers of my guild are really pushing hard and breathing down the tanks neck. I need all the treat i can get while at the same time keeping good surivial. Such a strange balance compared to the classic warrior setup from classic.

Scent of Blood: I also spam runestrike none stop and have it macros to my mouse 5 button to make spamming it very easy. I have stopped using a macro like !runestrike with things like /cast heartstrike so as to stop running dry on RP in times when i need to use a CD like IBF however when i complete a rune cycle there is a few seconds for me to throw a DC or two in to continue threat generation. I think you should gie it a test, would really like to know how you get on with it from the perspective of a experience dk tank.

Spell Deflection: I use AMS onboss magic speical abilities of course like lets say storm callers nova blast or a dragons breathe when I can see the cats bar, mimiron aswell. However referring to ulduar hardmode again because its mainy what i am being exposed to currently in fights like Thorim HM there is no castbar to prepare AMS and using it would be guess work at best. Even on mimiron the AMS will on absorb 1 tick of plasma blast unless your unholy and so the chance to parry really make a noticable difference. I cant say how good it is for pvp as I pvp in unholy and not blood.

Hysteria: Yea it does stack with bloodlust/heroism and it makes a noticable difference in the persons dps. It can be used 2-4 times in a fight depending on the fight and the dps'er will fall in love with you.

Blood Tap: I can certainly see its use and the first time I did Ignis I was tanking back then and it too saved me on that fight, however I wasnt having Tps issues.

And what you say is true its what best suits me and best suits this guild. I just want corrects on the theorys i might get wrong. I am thinking about taking out mark of blood, hysteria and maybe a point of scent of blood to get sudden doom but i dont know if this is worth it.


I have seen some of Satorri's thread's but not many, and i struggled to find anything of real use at EJ. If you could give me some links if you know any or have anything bookmarked I would be thankful.

The main ones I have found is the theory crafting on stats like amour, hp, avoidance, surivial and tps balance but not that much. Trying to work it out bu minly want to know if what im doing is right so far and if its no then what is right so as to gain some confidence in my tanking ability.

11-17-2009, 06:32 AM
Bloodworms: while the damage they do is 20-30 and there ment to heal u for he same amount, but there is aparently some kind of a bug in there that makes em heal u for a hell of alot more, intentional or not i dont know but they do heal you for a good 200+ each, they do die alot but when ever they last there a real gd help.

does ur guild start dpsing at the same time u start tanking? because they hit harder than u do from the start they get a huge aggro boost, so ask them to start dpsing like 3-4 seconds after u start.

Spell Defeltion: i can see how this would help in HM but ur not garanteed to get it activated all the time, and u have to be hit 1st place in order for it to activate, and it all depends on how high ur parry is, i dont really care much about parry, if it was dependent on dodge then yea id be more interested in this, and its only a handfull of bosses that use magic to hit u, even then they dhont hit u that often so i just think its a waste of points.

i will definatly be giving Hysteria a go.

Blood tap: yea this 1 is more of a luxury than a necessity, if ur having theat issuse then put the points else where.

id take the point out of mark of the blood, dont really need it, again its more of a luxury than a necessity, hysteria while it is good it dont really help with ur threat unless u use it on urself, if ur giving it to ur top dpser it would make it harder for u cuz there hitting harder so there gona make more aggro, and put them 2 points in improved blood pres, it will increse any healing done to u by 4% which might not seem like alot but will help, id leave ur 2 points in scent of the blood.

Gems and Enchant: id go for the socket gem bonus on ur shoulders n gloves, and id go for the +10 all stats on ur chest, while u do gain stats on useless things like interllect and sprit, it gives u 10 on every think so that includes things like u sed HP, tps, dps avoidence, while +10 isnt really alot, i think its just better alround cuz it gives u 10 on every think, id only use the defence enchant if ur under def cap, and the 275hp if u dont have much HP in the 1st place

11-17-2009, 09:00 AM
I ve done some testing and i dont see these worms healing for 200 each, maybe they heal that much when vamp blood is up?

In regards to threat yes they hit right off the bat because if they pause we wont make the enrage timer. Im able to handle it but if I take out tps talents I wont be able to, and and need to continuely increase it as there deeps go up aswell. Hysteria is used on a rogue at the start at the same time as he tricks me so the threat goes to me thus a tps boost for me.

Mark of the blood your right and same with hysteria, its a luxery.

With improved blood presence you need to re-read the tooltip. The increased healing done is when you in blood presence, you dont get it in frost. This is why its normally seen as a dps thing and not for tanks i think, not sure.

Im looking for more theory crafting answers though.

11-17-2009, 09:17 AM
Bloodworms are a very tricky entity for a few reasons:

1.) They have zero protection and no health, if there's any sort of aoe/cone/breath/cleave/aura damage they will have no lifespan, at all. No life, no healing.

2.) They have no pet scripting for positioning. They pop out next to you and dps as they stand. That means they are in front of the boss if you are tanking, and they can be parried. This *may* represent an increase in damage taken, though while I'm not particularly sure it will be more than the healing they cause, I suspect it will diminish that healing value a bit.

3.) Like Imp Blood Presence their heals are small and involuntary. They have no discernment for timing. The result is that there will be a lot of overhealing. The small size of the heals will mitigate that some, but the implications there is that you will see some total value after the fight, but it will not be saving your life, really, just giving a small, hard to perceive bump to your effective health.

To be clear though, the worms scale very lightly with your dps. *If* the worms live most of their life, they'll usually average somewhere around the same hps as Imp Blood Pres for 2-3 worms up, per point. That's a big 'if' though. To compare that will be roughly a quarter of your typical effective DS healing, or half of your Imp Rune Tap healing (if you use it well and often).

Mark of Blood and Improved Rune Tap, I consider to be very advanced skills to use well. When you first start tanking as a Blood tank, the rotation is simple enough, but these moves are hard to fit in well when also thinking about threat, positioning, and defensive CD use. *If* you cultivate your skills with these spells once you're more comfortable with all the other aspects, you can use them to fantastic effect (here's a fun tidbit, try using Mark of Blood on one of the Worms when they spew, or on Icehowl when he Frost Breaths, it will make them do virtually no damage, even on heroic). As opposed to Imp Blood Pres and Bloodworms, Imp Rune Tap is an absolute life-saver, but like I said, it takes skill, timing, and training to use. When my health dips I hit it without thinking. There is no watching or waiting, my fingers fire immediately and I can prop my health up by 25k-ish if I have the runes to fire a DS too. Rune Tap is off the GCD, so they can be used simultaneously.

11-17-2009, 09:25 AM
Also, as a side note, NOTHING should take precedence over Bladed Armor for threat. SoB included. In fact, until you're approaching 70% total avoidance (as Blood, which is virtually non-existent since that would require stacking avoidance and health is almost always your better bet with Blood, unless you have an atypical method), you won't see more value out of SoB beyond some comfort at the beginnings of fights, and some extra DC's (which are a little disappointing as threat values go to use GCD's unless you have a rune blackout, which is, in turn, a rare occasion because of the single-rune orientation of Blood).

Bladed Armor is the largest threat value for any DK tank that is not a specific spell or tree/play style ability (i.e. HS, HB, etc).

11-17-2009, 09:49 AM
thanks satorri that cleared alot up for me.

I really like using mark of blood and really enjoy using it when a boss does a aoe or mass raid hit and i see it heal everyone, twins is a nice example, though its such a long CD on it i try to save it for a 'aahhh crap' moment. I also used it on steelbreaker last HM just before it was my turn to taunt at the start to prepare and if I am used to tank algalon will do the same.

What you say about tune tap makes sense, i need to make it second nature if at all. At the moment i get a sound warning when my hp drops and when i hear that i hit my bindings for CD's depending what I got up, and on fights like gormokk i would have my ghoul up and ready to be death pacted for when my hp hits low. I guess tune tap is the very same. So many cd's!

What changes to my specc would you suggest?

edit- corrected typo's, hope i got them all. was typing in a rush

11-17-2009, 10:35 AM
thx satorri, cleared up a few things for me 2. u really do know ur stuff lol

@mikee Improved Blood Presence - Spell - World of Warcraft (http://www.wowhead.com/?spell=50371)

it says while ur in frost or unholy pres u retain 4% healing out of the 10% that u would get in blood

11-17-2009, 11:34 AM
No, that's not quite right, Ltseb.

You keep 2/4% of the 4% damage to healing you'd get from Blood Presence (http://www.wowhead.com/?spell=48266).

In addition to that, if you're in Blood Presence with this talent, you get a 5/10% increase to all healing done to you (from your own heals, and others').

11-17-2009, 11:53 AM
ok my mistake i thought u got an extra 4% from all heals, didnt realise it was just from ur own lol mybad, but still, it helps

11-23-2009, 01:22 PM
Mark of Blood and Improved Rune Tap, I consider to be very advanced skills to use well. When you first start tanking as a Blood tank, the rotation is simple enough, but these moves are hard to fit in well when also thinking about threat, positioning, and defensive CD use. *If* you cultivate your skills with these spells once you're more comfortable with all the other aspects, you can use them to fantastic effect (here's a fun tidbit, try using Mark of Blood on one of the Worms when they spew, or on Icehowl when he Frost Breaths, it will make them do virtually no damage, even on heroic). As opposed to Imp Blood Pres and Bloodworms, Imp Rune Tap is an absolute life-saver, but like I said, it takes skill, timing, and training to use. When my health dips I hit it without thinking. There is no watching or waiting, my fingers fire immediately and I can prop my health up by 25k-ish if I have the runes to fire a DS too. Rune Tap is off the GCD, so they can be used simultaneously.

I'm glad to see you say this Satorri. I had deviated from the cookie cutter build a bit to pick up Rune Tap and Mark of Blood because I felt my threat was pretty well established at the current tier of content and having specced into Rune Tap earlier I found that it was supremely useful when I tanked as Unholy up to 3.1. Just like you said, I hit it without thinking. When I see my healers are struggling I will hit Rune Tap and usually follow up with IBF just to buy some time.

As I did some reading today I had read several posts where specing into Rune Tap or Mark of Blood was absolutely shunned and anyone who even considered spending the talent points were deemed inexperienced but in my experience I have found it takes way more muscle memory and ability to read your runes to know whether you need it, whether it's available and whether you need to blood tap quickly to bring it up and save the raid. It's good to see a community luminary such as yourself lauding it in some way.

That being said I picked up Mark of Blood because Hysteria seemed horribly mis-spent in a tanking build but I'm considering putting a point back into it and taking the points I had oddly invested into Sudden Doom (honestly, was I drunk?) to better facilitate quick start-ups on boss encounters. Fortunately there are excellent lines of communication between me, the other tank (we don't designate a de-facto main tank in our raid team) and the healers in our raid group so I am curious to see if this helps to increase my threat output as we try for more difficult encounters.

11-23-2009, 05:13 PM
As opposed to Imp Blood Pres and Bloodworms, Imp Rune Tap is an absolute life-saver, but like I said, it takes skill, timing, and training to use. When my health dips I hit it without thinking. There is no watching or waiting, my fingers fire immediately and I can prop my health up by 25k-ish if I have the runes to fire a DS too. Rune Tap is off the GCD, so they can be used simultaneously.
/Same. Macro a Runic Healing Pot into Vampiric Blood and you've got a nice reactive oh-shit button for quickly recovering from spike dmg:

/use [mod:ctrl] whatever;[mod:alt] whatever;[mod:shift] whatever;[nomod] Vampiric Blood
/use [nomod] Runic Healing Potion
After you've just spiked down from 80% to 20%, and one more hit could kill you, pop this macro, then Improved Rune Tap, both of which can be done b/f the boss's next swing. Follow up with a Death Strike, and that usually gets me back to about 80% (50%-80% if the boss got off another swing b/f I could DS).

Gets you out of the dangerzone almost instantly, and provides a reactive, rather than preventative, cd. Afaik that's the only active DK cd that can deal with spike dmg after the fact, rather than requiring the player to somehow predict the unpredictable and pop a dmg reduction cd b/f RNG spike series hits.