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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:

Image
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?

 

Category
Firefighter Health & First Aid
References
Rhabdomyolysis in Wildland Firefighters (USFS)
Watch this video on rhabdomyolysis and wildland firefighters

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NWCG Latest Announcements

FAQ Now Available for Archiving Type 1 and Type 2 Incident Positions

Date: Aug 6, 2025
Questions? Please contact:
Incident and Position Standards Committee

To support the transition to Complex Incident Management (CIM), NWCG will archive all Type 1 and Type 2 Command and General Staff (C&G) position qualifications in January 2026, as outlined in NWCG Executive Board Memo 25-002. To assist with this transition, a new Frequently Asked Questions (FAQ) document is now available.

This resource answers common questions about the status of Type 1 and Type 2 qualifications, impacts to incident qualification management, training requirements, and resource ordering considerations. Review the full FAQ to learn more.

For additional information on CIM and the transition of C&G positions, see NWCG Executive Board Memos 23-005, 24-005, and 25-002, as well as the Incident Workforce and Development Group webpage.

References:

NWCG Type 1 & Type 2 Position Archiving FAQ

NWCG Executive Board Correspondence

Incident Workforce Development Group

Incident and Position Standards Committee

Incident Position Standards and the Next Generation Position Task Books Now Available for UASD, UASM, UASL and UASP

Date: July 31, 2025
Questions?  Please contact:
Interagency Fire Unmanned Aircraft Systems Subcommittee
 

NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Books are now available for all four Unmanned Aircraft Systems positions:

  • Unmanned Aircraft Systems, Data Specialist (UASD)
  • Unmanned Aircraft Systems, Manager (UASM)
  • Unmanned Aircraft Systems, Module Leader (UASL)
  • Unmanned Aircraft Systems Pilot (UASP)

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization effort. These resources support trainees, qualified personnel, and evaluators in their respective roles.

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 2026.

References:

NWCG Unmanned Aircraft Systems, Data Specialist Position Page

NWCG Unmanned Aircraft Systems, Manager Position Page

NWCG Unmanned Aircraft Systems, Module Leader Position Page

NWCG Unmanned Aircraft Systems Pilot Position Page

Incident Position Standards and the Next Generation Position Task Books Now Available for RADO and INCM

Date: July 30, 2025
Questions?  Please contact:
Incident Logistics Subcommittee
 

NWCG is excited to announce that Incident Position Standards and the Next Generation Position Task Books are now available for Radio Operator (RADO) and Incident Communications Center Manager (INCM).

The Performance Support Packages for these positions were developed as part of the Incident Performance and Training Modernization effort. These resources support trainees, qualified personnel, and evaluators in their respective roles.

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 2026.

References:

NWCG Radio Operator Position Page

NWCG Incident Communications Center Manager Position Page

ETC Equipment Bulletin: 25-004 NEW Aquatic Invasive Species – Golden Mussels

Date: July 29, 2025
Questions?  Please contact:
Equipment Technology Committee
 

The Equipment Technology Committee (ETC) issued Equipment Bulletin: 25-004, notifying the wildland fire community about a newly discovered invasive species and actions to take if found. Golden mussels, a highly invasive species recently identified in California, pose a significant risk to native ecosystems, infrastructure, and fire equipment. These mussels rapidly colonize hard and soft surfaces, including aquatic plants and fire equipment, clogging pipes, fouling motors, disrupting water systems, and impacting native species.

To help prevent their spread, fire personnel must follow the decontamination procedures outlined in the NWCG Guide to Preventing Aquatic Invasive Species Transport by Wildland Fire Operations, PMS 444. Additionally, report any sightings immediately to your Lead Resource Advisor and include clear, close-up photos and location details.

Read the complete ETC Equipment Bulletin: 25-004 to learn more. 

References:

NWCG Alerts

ETC Equipment Bulletin: 25-004

NWCG Guide to Preventing Aquatic Invasive Species Transport by Wildland Fire Operations, PMS 444