I live in NM and I cannot ride around the block without getting 5-10 goat heads stickers in my 4" fat tire bike. When I ride the dirt trails, I have goat heads and cactus thorns to worry about also. I also find myself dodging and weaving road debris on my ebike 13 mile total round-trip work commute on side/main roads (wood splinters, sharp rocks, broken glass from cars/bottles, car parts from accidents, more goat heads, etc...).
I find the combo of Mr. Tuffy tire liner and Stan's tire sealant has prevented flats for me for +4 years (4 years for the 700X40c Transeo bike and +4 month on my Radrover 4" fat tire). I usually remove the broken off goat head thorns buried deep in the rubber on the weekend. I don't want to be away from home and remove the thorn that might be keeping the air in my tire. I just use needle nose pliers; but, the ones buried really deep are easier to remove with the blade of a box cutter (scrape the top of the thorn until I can snag the side of goat head with the blade.
I ended up have 3 holes from goat heads with air leaking once I removed the thorn last weekend. I just rotated the tire until the tire sealant bubbled out, I made sure the tire was back to 20 PSI commuter pressure once the sealant/air stopped leaking, and just double-checked the PSI over a day or two.
I don't have any tools to repair bike flats or done nothing more than rotate my tires and checked the PSI in 4 years with the Mr. Tuffy+Stan's sealant combo.