Injuries from cactus spines can present challenges to Emergency Medicine providers. When the patient has mental limitations that prevent cooperation with removal, these challenges grow. Traditional removal techniques have several drawbacks including prolonged time for complete removal and incomplete removal. We present the case of a 22-year-old with a history of low-functioning autism and congenital motor dysfunction with a cactus spine injury to a large surface area of her chest, abdomen, and extremities. Conscious sedation utilizing intramuscular ketamine and Operating Room (OR) hair removal mitts were utilized to quickly and effectively remove the cactus spines. The patient had efficient, painless resolution of her injury without need for additional spine removal.