Acetaminophen Overdose & Toxicology Pearls History: Figure out how much was taken, what time the ingestion occurred, and if any other toxins were ingested Physical Exam: Perform a regular physical exam, and in addition, perform the toxicologic physical exam! Check pupil size Assess neuromuscular status for rigidity/clonus Perform the \u201ctoxicologist handshake\u201d Listen to bowel sounds [\u2026]