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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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NEW! NWCG Standard Operating Procedures, PMS 900

Date:  July 9, 2026
Questions? 
Please contact: NWCG Staff

NWCG is excited to announce the publication of the NWCG Standard Operating Procedures, PMS 900.

The new publication establishes general, consistent, and uniform standards for conducting business with the National Wildfire Coordinating Group.

References:

NWCG Standard Operating Procedures, PMS 900

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Questions? 
Please contact: Leadership Development Subcommittee

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Quarter Four materials focus on Leadership Level 4: Leader of Leaders (Provide Direction). Leadership Level 4 is where you are setting the conditions for others to do things well, even when you are not present. This quarter focuses on equipping experienced leaders with skills to provide direction, build trust across teams, and foster strong decision making. 

References:

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Date:  June 30, 2026
Questions? 
Please contact: 6 Minutes for Safety Subcommittee

As we approach the 2026 Week of Remembrance (WOR), June 30–July 6, we dedicate this time to reflect on past incidents from 2016 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 that promote a culture of continuous learning and safety.

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RMC Memorandum 26-02: SAFENET Modernization and SafeNetX Launch

Date:  June 25, 2026
Questions? 
Please contact: Risk Management Committee

The Risk Management Committee (RMC) is pleased to announce the launch of SafeNetX, the modernized safety reporting system now available to the wildland fire community. Effective June 15, 2026, SafeNetX enables reporting of unsafe, unhealthy, near-miss, and high-risk operations across wildland fire, all-hazard incidents, training, and related work environments.

SafeNetX is the result of a multi-agency modernization effort led by RMC, which began evaluating improvements to the legacy SAFENET system in 2021. To learn more, read the full RMC memorandum in the links provided.

References:

SafeNetX

RMC Safety Memorandum 26-02: SAFENET Modernization and SafeNet X Launch