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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

Leadership Committee IAP Flyer Now Available

Date:  May 8, 2026
Questions? 
Please contact: Leadership Committee

The NWCG Leadership Committee promotes and enables leadership development across the wildland fire service. The committee provides education, training opportunities, and support for leadership innovation and best practices throughout the community.

A new IAP flyer is now available on the committee website, offering an overview of the products, curriculum, and learning opportunities the Leadership Committee develops. This resource is ideal for posting in your office, sharing with new employees, or distributing through your incident management teams to engage new voices in the leadership journey and reinforce a culture of self‑reflection, development, and growth.

References:

Leadership Committee 2026 IAP Flyer

Incident Operations Subcommittee Updates the Next Generation Position Task Book for FFT1

Date:  May 7, 2026
Questions? 
Please contact: Incident Operations Subcommittee

The NWCG Incident Operations Subcommittee (IOSC) has updated the NWCG Position Task Book for Firefighter Type 1 (Squad Boss) (FFT1), PMS 311‑14. The FFT1 Position Task Book transitioned to the Next Generation (Next Gen PTB) format in June 2025 through the Incident Performance and Training Modernization effort. Since then, IOSC has received feedback from the wildland fire community regarding coding for one of the tasks. Task #13 has been updated to include the option of evaluation in a simulation.

See IOSC Memorandum 26‑01: Transition Plan for Implementation of Updates to the NWCG Position Task Book for Firefighter Type 1 (Squad Boss) (FFT1), PMS 311‑14 for more information.

References:

IOSC Memorandum 26-01: Transition Plan for Implementation of Updates to the NWCG Postion Task Book for Firefighter Type 1

NWCG Firefighter Type 1 Squad Boss Position Page 

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