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Week of Remembrance

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

2025 Week of Remembrance

Date: June 27, 2025
Questions?  Please contact:
6 Minutes for Safety Subcommittee

As we approach the 2025 Week of Remembrance (WOR), June 30–July 6, we dedicate this time to reflect on the past incidents from 2015 and honor the fallen through learning. Since its inception in 2014, WOR has honored wildland firefighters who made the ultimate sacrifice while encouraging critical discussions that reinforce lessons learned.

Throughout the week, we encourage thoughtful and generative conversations—whether in briefing rooms or at tailgates—that promote a culture of continuous learning and safety.

References:

2025 Week of Remembrance: Letter to Leadership

Wildland Fire Lessons Learned Center

ETC Equipment Bulletin: 25-003 Flame-Resistant Shirt Survey

Date: June 12, 2025
Questions?  Please contact:
Equipment Technology Committee

The U.S. Forest Service National Technology and Development Program (NTDP) is seeking input on the Forest Service-designed flame-resistant (FR) shirt, currently available through the National Interagency Support Cache system and FedMall.

NTDP is conducting a product review to improve future FR shirt designs. As part of this effort, a short survey is now open for federal employees who have worn any of three recent FR shirt models. Feedback will guide design improvements to better meet the needs of wildland firefighters.

To comply with the Paperwork Reduction Act, responses are limited to federal employees. The survey is open through September 12, 2025. 

References:

NWCG Alerts

ETC Equipment Bulletin: 25-003

NEW! S-130, Firefighter Training (Blended) Now Available

Date: June 10, 2025
If you have questions, please visit our FAQ page. 
If your question is not answered there, you can 
submit your question using our Contact Us form. 
 

The S-130, Firefighter Training (Blended), equips new wildland firefighters with essential skills through a mix of online learning and hands-on training. The course features a required online component and an instructor-led exercise, reinforcing online concepts with practical performance-based training.

The course builds competencies in wildland fire operations, safety, and equipment use, applicable across various operational environments. Both the online component and instructor-led field exercise must be completed to receive a certificate of completion. Students are required to finish the prerequisite S-190, Introduction to Wildland Fire Behavior, before enrolling in S-130, Firefighter Training (Blended).

References:

S-130, Firefighter Training (Blended)

S-190, Introduction to Wildland Fire Behavior

Wildland Fire Learning Portal

EMC Memo 25-001: Interim Rapid Extraction Module (REMS) Training and Qualification Requirements

Date: June 3, 2025
Questions?  Please contact:
Emergency Medical Committee

The Emergency Medical Committee has issued interim guidance for Rapid Extraction Module Support (REMS) teams. Until further notice, Type I and II REMS teams must designate a team leader qualified at Firefighter Type 1 Squad Boss (FFT1) or higher. This temporary change replaces the Single Resource Boss (SRB) requirement, which is currently not feasible due to administrative barriers.

This memorandum does not include any other changes to the NWCG Standards for Rapid Extraction Module Support, PMS 552. This interim change takes effect immediately and will remain in place until further notice.

References:

EMC Memo 25-001: Interim Rapid Extraction Module (REMS) Training and Qualification Requirements

NWCG Standards for Rapid Extraction Module Support, PMS 552