Previously, the guidelines indicated that a pulse check should be performed after the breathing was assessed, and this made up the 'circulation' part of the initialism, but this pulse check is no longer recommended for lay rescuers. Some trainers continue to use circulation as the label for the third step in the process, since performing chest compressions is effectively artificial circulation, and when assessing patients who are breathing, assessing 'circulation' is still important. However, some trainers now use the C to mean Compressions in their basic first aid training.