This could be done in a couple of different ways. First of all, you could assign a big bonus to the task at hand, and assign some level of hurt—the level of hurt may be determined by a separate contest, with even a minor success indicating a wound, and failures resulting in progressively more grave injury. In return the role for the task gets a big boost, perhaps +10 or even a whole mastery (i.e. while it is almost impossible to run into the fire and get your sister out without being hurt, it is quite possible to rush through the flames and get her out before the fire and smoke incapacitate you). This can be used for either a simple or extended contest.
Another way of doing this in a simple contest or an extended contest starting from the beginning, is to simply state the terms of the contest differently. Instead of the result determining if you get your sister out of the fire, instead you get her out on anything other than a complete defeat, and the level of success or defeat indicates what shape you are in when you get out. This option does not work for one exchange in the middle of an extended contest however, as the goals of the contest are already pretty much set.
Note that in an extended contest, the most likely time to do this is as a last gasp action. In this case, no special rules are really needed, instead the self-sacrifice is the justification for taking one last action. "You are at –5 AP. He's disarmed you and you are on your knees, holding only your dagger, and he has his sword to your throat." "I want to take a last gasp action, bidding my whole starting 37 AP. I'll grab his sword and pull it down and towards me, even if that stabs it into my gut. That will pull him down, and I'll plant my dagger into his thoat." "You know if you fail you could be dead?" "That is what HP are for!" In such an exchange, many times both combatants could end up at negative AP, so clearly the explanation at that point is that the damage from your negative AP is due to this action.
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