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Almost Killed by a Cactus: A True Story

This March during an orienteering competition in Florida, high school sophomore Joshua Reyes heard another racer whistling for help. It was Micah Robinson, who was trying to get himself out of a sticky situation.

In a Hernando (Fla.) Today newspaper story, Joshua explained, "He'd fallen face first into a cactus, and he had those little quills all over his hands and stuck in his face all around and inside his mouth. I helped pick the quills out of his hand, but as he stood up, he was dizzy. I knew I had to get him back."

Joshua led Micah to the race's starting point and somebody called 911. By this time, Micah was having trouble breathing. Paramedics arrived, gathered a sample of the cactus and transported Micah to the hospital. Later, in the emergency room, a nurse confirmed that Micah had a serious allergic reaction to the cactus.

Yes, cactus can and do grow in Florida. Who knew?

In addition to the familiar cactus spines, all genus Opuntia cacti (the largest genus of cacti) also sprout minute, barbed hairs called glochidia. The large spines are painful when they poke holes in you, but the tiny glochidia are more medically problematic.

When glochidia implant themselves—sometimes merely brushing a cactus injects them into your skin—they can cause irritation that may last for up to 9 months! Shiny, fluid-filled papules with a black center can form. (See photo.) Additionally, some patients will experience soft tissue infection or an allergic reaction.

Microscopic cactus barbsRemoving spines and glochidia is difficult because these structures are barbed. That is, they have microscopic hooks (shown at left) along their lengths that do a great job at anchoring into your skin.

Pull out spines with tweezers if you can. Never, ever try to use your teeth to remove spines from your body. (You would be shocked to know how frequently people do this. They always end up with spines or glochidia in their tongues, lips and faces.)

In a 1987 study*, doctors actually evaluated various popular methods of removing the tiniest spines. They compared tweezers (no explanation needed), adhesive tape (stick it to the skin and then rip it off; hopefully the spines stick to the tape), facial mask (some folks smear spa product on the affected skin, allow it to set and peel it off hoping the spines are pulled out as well) and even Elmer's glue. The results?

Popular technique vs. success rate
•    Pull with teeth = 0% of spines removed (plus friends laughed at you)
•    Adhesive tape = 30% of spines removed, major irritation caused
•    Adhesive tape, multiple times = 30% of spines removed, major irritation caused
•    Facial mask = 40% of spines removed, major irritation caused
•    Elmer's glue on skin, with gauze = 63% of spines removed, no extra irritation
•    Tweezing = 76% of spines removed, no extra irritation
•    Tweezing plus Elmer's glue = 95% of spines removed, no extra irritation

Don't touch cactus spines!Their final recommendation was to first remove as many spines as possible with tweezers. Then, spread a thin layer of household glue on the skin and cover it with gauze. Allow the glue to dry for 30 minutes before peeling it off with the gauze.

If you miss some spines and painful pustules form, then it's time to go to your doctor's office for more advanced removal techniques.

You probably don't need to add glue to your first-aid kit for wilderness trips, but it's good to know how to get the most spines out once you get home. Of course the best strategy of all, young Micah, is to not face-plant into a cactus in the first place!
- - -
To learn more about wilderness medicine, visit WMI of NOLS. For a more comprehensive look at spiky plants, find an excellent article in Dermatology Online Journal V7, No. 2.

* Reference: Martinez TT; Jerome M; Barry RC; Jaeger R; Xander JG. Removal of cactus spines from the skin. A comparative evaluation of several methods. American Journal of Diseases of Children, 1987 Dec, 141(12):1291-2.

Posted on at 12:34 PM

Tagged: NOLS, WMI, Wilderness Medicine Institute, cactus and wilderness first aid

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