A wearable defibrillator includes a plurality of ECG electrodes removably attached to a patient and configured to sense a cardiac condition of the patient, and at least one therapy pad configured to deliver electrical therapy to the patient. The wearable defibrillator may include a microphone configured to receive an audio input and sense environmental noise and a speaker configured to output one or more alarms signaling that treatment is about to be provided to the patient. At least one processor of the wearable defibrillator is operatively connected to the plurality of ECG electrodes, the at least one therapy pad, a memory, and the at least one audio device. The at least one processor is configured to monitor the sensed cardiac condition and increase a volume of the one or more alarms when the microphone senses from the environmental noise that the wearable defibrillator is in a high noise environment.