Lessons Learned Review: Rhabdomyolysis leading to heat stroke

Heat stroke and rhabdo
PT run trail
Trail on which the PT run was conducted. NPS photo.

A Lessons Learned Review (LLR) for an unusual but severe injury has been released. A firefighter working for the National Park Service at Sequoia and Kings Canyon National Parks in California developed rhabdomyolysis (rhabdo) during his first week of work this season, probably after his first day which included very strenuous physical training. Then four days later, on June 27, 2013, he suffered from heat stroke during a training run. Recent research indicates that muscle damaging exercises can increase heat strain during subsequent exercise.

The firefighter was treated by NPS medics at the scene and then transported by a California Highway Patrol helicopter with a paramedic on board. He arrived at a Level I trauma center within one hour and thirty three minutes of his collapse while running. The doctor at the hospital told his parents that he was “…a profoundly sick young man, who may not make it.” He was hospitalized for two weeks and underwent kidney dialysis three times a week for seven weeks; reduced to once a week at the time the report was written, and was projected to make a full recovery. He hopes to return to light duty work, but cannot do so until he is finished with kidney dialysis treatments.

An excerpt from the report:

The LLR Team would like to commend the EMS responders, both from the NPS and the CHP, for their quick- thinking and actions. The LLR Team is certain that if these employees had not done so, [the firefighter’s] injury would have proved fatal.

The report, written by a four-person team that included an Exercise Physiologist with a PH.D., is very well written. It includes numerous recommendations for sustaining good practices as well as suggestions for improving the handling of rhambdo and other serious injuries, both locally and nationally.

All firefighters should read this Lessons Learned Review.

Heat stroke and rhabdoMore information and heat illness and its prevention.

Other articles at Wildfire Today about rhabdomyolysis.


Typos, let us know HERE, and specify which article. Please read the commenting rules before you post a comment.

Author: Bill Gabbert

After working full time in wildland fire for 33 years, he continues to learn, and strives to be a Student of Fire.

5 thoughts on “Lessons Learned Review: Rhabdomyolysis leading to heat stroke”

  1. Thank goodness this young man will recover!
    Kudos to the emergency personnel to get him treatment and save his life!

  2. Speaking only as the mother of Caleb Hamm, everyone in the fire world I have ever come across say the same thing: until the day comes that “speaking up” when you don’t feel well isn’t frowned upon, and your job isn’t at risk, this topic will remain in the shadows. No one wants to acknowledge HRI’s happen. Is seen as a “weakness”. The BLM was unwilling to accept Caleb didn’t have any underlying condition. They searched and searched for somethinig. I knew he didn’t have any drugs/alcohol in his system. But, boy did they try to prove he did. Thank God we had the insight to ask for the toxicology report asap!!
    This is only the tip of the iceberg. You will continue to see HRI’s, watch the weather and fire patterns, it is only a matter of time until someone has the guts to stand up and say enough is enough, let’s get our act together and implement change.
    I wait for that day, knowing in the meantime, it continues……….

  3. Over the course of the last several years I have posted a significant amount of information regarding rhabdo as it relates to wildland fire.

    Much of this has been posted on wildlandfirecom within “they said”. There is also a article that I posted to the International Association of Wildland Fire couple of years ago.

    This topic is something that warrants more knowledge and understanding by all parties involved within wildland fire.

    If you would like more information, please feel free to research the topic within those areas.

    If Bill would like, I can send him both the articles so that he might post them to get the word out.

  4. There is quite a bit of information about rhabdo on the cross fit site. Basically, you need to work up slowly to the really intense level of exercise wild land firefighters train at these days.

    1. Not necessarily always the case. I agree, a person needs to be in good physical shape to take the WCT and to do fireline work. But In 2011, I had gone on 5 out of state fire assignments and did alot of fireline walking with my pack in hot weather conditions. I took the WCT in September after coming back from my 5th fire assignment. I developed compartment syndrome and rhabdo and almost didn’t make it. And, at the time, considered myself in real good shape. It happened and it has happened to other people in good shape. Just my $.02


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