Skip to main content

6MFS

6MFS Committee

All 6MFS Topics

6MFS Calendar

Aviation

Airtankers

Felling Safety

Fire Communication

Firefighter Health & First Aid

Leadership

Misc Fireline Hazards

Operational Engagement

This Day in History

Vehicles - Roads

Weather - Fire Behavior

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

Last Modified / Reviewed:


Have an idea or feedback?

Share it with the NWCG 6MFS Subcommittee
 


Follow NWCG on X and Facebook
 


 

Print PDF

NWCG Latest Announcements

Updated NWCG Standards for Wildland Fire Resource Typing, PMS 200 Now Includes Off-Highway Vehicle Typing Standards

Date: May 13, 2025
Questions?  Please contact:
Mobile Fire Equipment Subcommittee 

The NWCG Standards for Wildland Fire Resource Typing, PMS 200 has been updated to include newly developed Off-Highway Vehicle (OHV) typing standards. These standards organize OHV information into logical categories and outline key safety requirements for occupants.

NWCG Standards for Wildland Fire Resource Typing, PMS 200 establishes minimum typing standards for aircraft, crews, and equipment used in national mobilization to wildland fire incidents. Typing designations are assigned based on measurable capability and performance criteria.

References:

NWCG Standards for Wildland Fire Resource Typing, PMS 200

NEW! S-204, Interpersonal and Critical Thinking Skills for Safety Officers Now Available

Date: May 12, 2025
Questions?  Please contact:
Risk Management Committee

The S-204, Interpersonal and Critical Thinking Skills for Safety Officers self-directed online course is now available! Developed through the Incident Performance and Training Modernization (IPTM) effort, this training supports individuals working towards Safety Officer, Field (SOFF) incident qualifications.

S-204, Interpersonal and Critical Thinking Skills for Safety Officers focuses on facilitating hazard mitigation conversations and building trust to influence safety-related decisions. Individuals can self-enroll through the Wildland Fire Learning Portal (WFLP).

Any changes to qualification pathways will take effect with the next update of the NWCG Standards for Wildland Fire Position Qualifications, PMS 310-1.

References:

S-204, Interpersonal and Critical Thinking Skills for Safety Officers 

NWCG Safety Officer, Field (SOFF) Position Page

Wildland Fire Learning Portal

Great Basin Cache Upgrading to New Inventory System

Date: May 7, 2025
Questions?  Please contact:
Great Basin Cache
Phone: (208) 387-5104
Fax: (208) 387-5573

The Great Basin Cache (GBK) is transitioning to a new inventory system to better serve the wildland fire community. During this upgrade, GBK will be unable to process standard orders from Part 1: Fire Supplies and Equipment and Part 2: Publications between May 8-20, 2025, with exceptions made for emergency fire orders. Orders will be accepted through close of business May 7.

To browse the latest available items, please refer to the National Fire Equipment System (NFES) catalogs. 

References:

NWCG NFES Catalog-Part 1: Fire Supplies and Equipment, PMS 449-1

NWCG NFES Catalog-Part 2: Publications, PMS 449-2

NEW! Air Operations Summary (ICS 220 WF) Now Available

Date: May 2, 2025
Questions?  Please contact:
National Interagency Aviation Committee

The Air Operations Summary (ICS 220 WF) provides the Air Operations Branch with the number, type, location, and specific assignments of helicopters and air resources. The new ICS 220 WF also includes medical extraction capabilities and air resources tracking.

Understanding the capabilities of aviation assets is critical for effective medical and extraction responses. Coordination with the Medical Unit Leader is essential to ensure alignment and consistency between the ICS 220 WF and the Medical Plan (ICS 206 WF). 

References:

Air Operations Summary (ICS 220 WF)

National Interagency Aviation Committee

Incident Command System (ICS) Forms