All vital signs (Temp, RR, HR, BP) + bedside glucose
Neurologic exam
Level of consciousness
Pupillary exam
Motor response
DTRs
Skin Exam - moisture, temp, evidence of injection drug abuse
Lung Exam
Bowel Sounds
ECG (ie. look for QT prolongation, QRS prolongation, etc)
Consider CBC, BMP, urinalysis (with ẞ-HCG if appropriate), urine<unk> screen, serum alcohol concentration, VBG
The urine screen is a qualitative test -> positivity ≠ acute toxicity
It can be falsely positive due to cross-reactivity
It can be falsely negative if the substance ingested does not cross-react with the tested analyte
The diagnosis of intoxication is clinical!!!
Level of consciousness
Pupillary exam
Motor response
DTRs
The urine screen is a qualitative test -> positivity ≠ acute toxicity
It can be falsely positive due to cross-reactivity
It can be falsely negative if the substance ingested does not cross-react with the tested analyte
The diagnosis of intoxication is clinical!!!
Toxicology 
Altered Metabolism
Dermatologic nomenclature
Aspirin 
Aria Health 
Withdrawal states 
Sign out tools
Thyroid hormones