These directives are designed to be used by nurses in an occupational health nursing program. These procedures outline the nurses' role in the handling of emergent and non-emergent situations in the occupational health care setting. As is the case with all occupational health "best practices", accurate documentation is of the utmost importance. There is a plethora of different onsite occupational health nursing services. Not every employer will use every available service. It is also important to note that some employers may have unique needs. It is not the purpose of this document to be all-encompassing or to substitute as a compendium of occupational health practice. Therefore, there may be times when an employer will request an occupational health nursing service that is not addressed within this guideline. When that occurs, the request should be submitted to the medical director for review. If appropriate, addenda to these guidelines regarding the specific request will be issued and are to be considered an extension of this document. In every instance, the recommendations contained within these guidelines are based upon evidence-based literature. It should be understood that in some areas, the evidence is weak or does not exist. In these instances, consensus recommendations are provided. It should be understood that health care is both art and science. Since it is ever-evolving, the recommendations contained within these guidelines may become obsolete or incorrect as new information is published. It is for this reason that these guidelines are to be reviewed at least on an annual basis.