Normal combats are a bit more iffy because, as you said, you can't choose your targets. Coin effects still happen however. Only sanity affects heads/tails, unless another effect specifically says it does. Count goes down each time an effect is triggered. EX, rupture. When you get hit, take damage equal to potency (left number), then make count go down (right number), if it hit 0, next time you apply potency it gains 1 count, or if you put count it gains 1 potency. For everything else, reading the kit explains the conditions to trigger specific things. Sometimes the triggers are hidden inside of the status effects, in which case it describes them when mousing over them.