Novel Method for Removing Embedded Cactus Spines in the Emergency Department

Area of Science:

• Emergency Medicine
• Dermatology
• Pain Management

Background:

• Cactus spine injuries pose significant challenges in emergency medicine, particularly with patients exhibiting mental limitations.
• Traditional spine removal methods are often time-consuming and may result in incomplete extraction.

Observation:

• A 22-year-old patient with autism and motor dysfunction sustained extensive cactus spine injuries to the chest, abdomen, and extremities.
• The patient's condition precluded cooperation with standard removal techniques.

Findings:

• Conscious sedation using intramuscular ketamine was administered.
• Operating Room (OR) hair removal mitts were employed for efficient and effective cactus spine extraction.
• The patient experienced rapid, painless resolution of the injury without requiring further intervention.

Implications:

• This case highlights a novel, effective approach for managing extensive cactus spine injuries in uncooperative patients.
• The combined use of ketamine sedation and specialized mitts presents a promising alternative to traditional methods.
• This technique can improve patient outcomes and reduce provider burden in managing challenging cactus spine exposures.