The second generation E-Scope® II has just been released. It is intended for general clinical use, medical education, Telemedicine and paramedic use in ambulances and medical helicopters. It amplifies the heart, breath, bowel or korotkoff sounds without amplifying outside noise. The E-Scope® II has maximum amplitude or sound pressure level output of 120 dBa without distortion. Additionally, heart or lung sounds are amplified without appreciable amplification of room or background noise. This makes it much easier to hear a low, rumbling murmur or faint AI blows.