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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

Intermediate Faller (FAL2) Position Task Book Update

Date:  July 24, 2026
Questions? 
Please contact: Tree Felling Subcommittee

NWCG Operations Management Committee (OMC) has issued an update to the NWCG Position Task Book for Intermediate Faller (FAL2), PMS 311-91. To ensure clarity for both trainees and evaluators, the updated FAL2 Position Task Book (PTB) explicitly states who is authorized to sign off on your tasks:

“Evaluators must be qualified as a FAL2, or an Advanced Faller (FAL1).”

If you are currently working out of a previously published version of the FAL2 PTB, you do not need to restart. However, OMC highly encourages you to take the following step to prevent any confusion in the field:

  • Print and replace the updated evaluator information page (page 2) in your current physical PTB.

References:

Intermediate Faller (FAL2) Position Page

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

NWCG Position Task Book for Intermediate Faller (FAL2), PMS 311-91

Equipment Advisory 26-001: Potential Front Driveline Joint Failure on 2018 and Earlier Ram Pickups

Date:  July 10, 2026
Questions? 
Please contact: Equipment and Technology Subcommittee

The Logistics/Equipment Management Committee (LMC) has released Equipment Advisory 26-001: Potential Front Driveline Joint Failure on 2018 and Earlier Ram Pickups. This advisory highlights multiple U.S. Forest Service regions reporting front driveline joint failure incidents.

This advisory recommends firefighters and fire managers to: 

  • Follow all Ram-issued inspection, maintenance, and service guidance for front driveline joints. 
  • Consider installing a driveline loop. 
  • Coordinate with fleet managers and service providers to determine the most appropriate driveline loop kit for each pickup.

For further details, please refer to the complete advisory.

References:

Equipment Advisory 26-001: Potential Front Driveline Joint Failure on 2018 and Earlier Ram Pickups

Technical Service Bulletin: 03-002-21

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

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

Date:  July 8, 2026
Questions? 
Please contact: Leadership Development Subcommittee

NWCG is excited to announce that Fourth Quarter 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 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:

2025/2026 NWCG Leadership Campaign - Leadership Levels

Wildland Fire Leadership Development Program

Leadership Development Subcommittee