The E-Scope EMS utilizes a set of aviation-style headphones to minimize outside noises allowing the user to optimally hear heart and breath sounds. E-Scope EMS is perfect for use in ambulances, helicopters, emergency rooms, stress test labs, naval vessels (surface and submarine), or any other high-noise area. A stethoscope cable is connected on one side with control buttons convenienly located on the stethoscope head. The maximum output of the E-Scope ems is 122 dB SPL without distortion.