You see a threat, you stay in CQB formation and you have clear LOS with hostile and no threat to friendlies. You take the shot, no hesitation no second thoughts.
Hearing protection gets a lower priority when death comes racing at you from many directions. That's an issue of fire discipline, weapons that are of extreme noise level tend to be kept out of CQB operations. (example, a .50 cal Barett Antimaterial Sniper rifle).