How to Stay Safe at Summer Concerts -- From Hydrating to Moshing

May 21, 2013— -- Singer Miguel tweeted that he just "got caught up in the moment" when he leapt over the crowd at the Billboard Music Awards and landed on a fan's face Sunday night.

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The televised accident serves as a reminder that although most concert-goers find themselves in the medical tent because they're dehydrated, more serious injuries can happen.

For instance, concert medical tent volunteer Penny Miller said she watched in horror when a Rolling Stones fan fell from a third-floor stadium balcony, bounced off the second floor balcony and fractured his skull at the Oakland Coliseum in 1981.

"He only lived to tell the tale because he received medical care right on the spot," said Miller, a nurse practitioner in Sacramento, Calif., who has volunteered for Rock Medicine since 1977.

Concert injuries vary depending on the performer, said Gordon Oldham, who directs Rock Medicine, a 40-year-old volunteer organization that provides free "nonjudgmental" medical care at more than 700 concerts and events in Northern California each year.

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For example, the Grateful Dead fans are going to have different medical needs than the hard-core punk crowd, which forms "mosh" pits at in front of the stage, where people slam-dance into each other, said Oldham.

"There's pit etiquette," Oldham said. "If somebody falls down, they help them back up."

Artists often stop playing their instruments and announce that they'll start again only after an injured person has been able to leave the pit and get medical attention, Oldham said.

But between stage dives and panic attacks, even the best crowd can experience a situation that gets out of control.

"If you're in front of the stage at a rock concert, you have to prepare yourself as a fan that anything can happen," Oldham said. "Nobody goes to get hurt. Nobody wants to get hurt. Nobody wants to see anybody get hurt, but sometimes it happens."

And Rock Medicine promises to take care of concert-goers without handing them over to police afterward if they've broken a law, Oldham said. That trust keeps patients from avoiding medical care when they need it.

"It's a person who may have made a bad choice today," Miller said, adding that concert-goers often drink more than they can handle. "They don't necessarily need to be arrested."

That willingness to seek on-site medical help also keeps concert-goers from clogging up emergency rooms with minor health problems, Miller said. At a recent three-day festival, Rock Medical treated 300 people and only had to send six to the hospital, Oldham said.

Dehydration is perhaps the most common health concern at concerts because people stand in line starting early in the morning to get into an evening concert, but they often forget to drink enough water, said Rapheal Castellanos, the president of the Central Park Medical Unit, which provides free care to the park's 35 million annual visitors and handles summer concerts.

"The first thing to do is make sure you have enough water with you – and also something to eat," Castellanos said. "Some folks don't eat all day because they want to get a place on line."

He said when people start to feel faint, get dizzy, have an altered mental state or feel disoriented; they should head over to the medical tents. These can all be signs of dehydration.

On a hot day, outdoor concert-goers also run the risk of heat exhaustion or heat stroke. Heat exhaustion usually involves excessive sweating, and heat stroke -- the more serious of the two -- occurs when the body is overheated but can't sweat.

"That's really a true emergency," Castellanos said. "You have to get cooled down and sent to the hospital."