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Exertional Rhabdomyolysis

 

Rhabdomyolysis, or “rhabdo,” is a medical condition where muscle tissue breaks down and the by-products of this process may lead to kidney failure and other complications. 

Rhabdo is commonly mistaken for heat illness or dehydration, so early recognition is critical. 

Exertional rhabdo can result from excessive exercise, physical training, or work. Wildland firefighters are engaged in strenuous activities and prolonged exertion often under harsh environmental conditions and difficult terrain–and so are at increased risk for exertional rhabdomyolysis. 

It is not possible to diagnose rhabdomyolysis in the field because specialized blood tests and a clinical evaluation by a professional are necessary. 

Contributing Factors:  

  • Sudden intense increase in physical exertion after periods away from activity such as occurs with poor conditioning and/or lower fitness levels.
  • Overexertion such as during high-intensity or long-duration activities without adequate recovery time.
  • Heat stress or working in extreme heat.
  • Excessive caffeine intake.
  • Dehydration.
  • Over the counter medications (decongestants, antihistamines, NSAIDs).
  • Prescription medications (antidepressants, statins).
  • Supplements such as creatine.

Treatment: Stop your current activity. Seek immediate care at the nearest hospital.

Rhabdomyolysis–Watch Out Situations:

Plastic cup with very dark urine.
  • Extremely sore for more than 3 days.
  • Soreness extends beyond muscles that were exercised→ i.e., the full body.
  • Soreness that feels out of proportion to the exercise done.
  • Stiffness and decreased range of motion.
  • Nausea, vomiting, headache, confusion.
  • Swelling in the arms and legs.
  • Dark, cola colored urine; gradually getting darker.
  • Extreme fatigue and/or weakness.

Key Recommendations:

  • Listen to your body!
  • Maintain your physical training program, nutrition, hydration, and rest.
  • Introduce new exercises slowly.
  • Keep open lines of communication about fitness, rhabdo, and other injuries/ailments.

Discussion Questions:

  • Given we have a very physical job, what would excessive pain, fatigue, and cramps look like to you?
  • What is your crew’s medical plan for rhabdomyolysis?
  • What are specific steps you and your crew can take to prevent and respond to this condition?

References:

Category
Firefighter Health and First Aid

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NWCG Latest Announcements

NEW! S-212, Intermediate Faller (Online) Course Available Now 

Date:  April 23, 2026
Questions? 
Please contact: Hazard Tree and Tree Felling Subcommittee

NWCG is pleased to announce that the new S‑212, Intermediate Faller (Online), course is now available on the Wildland Fire Learning Portal (WFLP). This second course in the series provides students with the knowledge and skills required to perform the duties of an Intermediate Faller (FAL2), as described in the FAL2 Incident Position Description. This course is intended for individuals seeking to advance from Basic Faller (FAL3) to FAL2.

S‑212, Intermediate Faller is a fully online, self‑paced training program consisting of 13 units. Learners will engage with interactive, scenario‑based content designed to progressively build foundational skills and knowledge essential for the FAL2 role.

Students must be qualified as a Basic Faller (FAL3) prior to enrolling in S‑212, Intermediate Faller course.

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1, scheduled for January 2027.

References:

S-212 Intermediate Faller (Online)

RMC Memo 26-01: Transition Plan for Implementing Updates to Intermediate Faller (FAL2) Position Qualifications

Intermediate Faller (FAL2) Position Page

NWCG Standards for Wildland Fire Chainsaw Operations, PMS 212

New Aircraft Flight Schedule Form, PMS 249

Date:  April 17, 2026
Questions? 
Please contact: National Coordination System Committee

A new publication from the National Coordination System Committee (NCSC) is now available. The NWCG Aircraft Flight Schedule Form, PMS 249, will be used for aviation crews and dispatch to share flight information that is needed for resource tracking, and if needed, for emergency procedures.

For further details, please contact your NCSC representative. 

References:

NCSC Memo 26-01: Implementation of NWCG Aircraft Flight Schedule Form, PMS 249

NWCG Aircraft Flight Schedule Form, PMS 249

New Glossary Term for Review

Date:  April 15, 2026
Questions? 
Please contact: Data Standards and Terminology Board (DSTB)

The Data Standards and Terminology Board is requesting feedback on a new glossary term: Resource Protection Measure (RPM).

The proposed definition is: Practical guidance provided for incident personnel in a manner in which incident objectives can be achieved while reducing impacts to identified resources across the landscape. RPMs are informed by, but not restricted to, Minimum Impact Strategies and Tactics (MIST).

Please review, share with your subgroups, and provide feedback as appropriate through the following form: Request Feedback The comment period will close May 10, 2026.

Thank you for your engagement in the NWCG glossary process – your participation is key to our success.

References:

Glossary Request Feedback

Quarter Three Materials for the 2025-2026 Wildland Fire Leadership Campaign Now Available

Date:  April 1, 2026
Questions? 
Please contact: Leadership Committee

NWCG is excited to announce that Quarter Three materials for the 2025/2026 Wildland Fire Leadership Campaign are now available. This annual initiative offers all students of leadership and wildland fire management an opportunity to engage with essential leadership skills and knowledge needed to lead effectively in dynamic environments.

Quarter Three materials focus on Leadership Level 3: Leader of People (Develop Intent). Leadership Level 3 is where your values, your team, and your influence come together. Leaders of People put their teams first, build trust, and lead with authenticity. They mentor future leaders and shape decisions up and down the chain.

References:

2025/2026 NWCG Leadership Campaign - Leadership Levels

Wildland Fire Leadership Development Program

Leadership Committee