A man was airlifted to hospital after falling on coastal rocks.
The 21-year-old suffered neck and spine injuries after the incident near North Berwick, East Lothian.
The alert was raised after two people heard the man, who was well equipped, blowing his emergency whistle for help.
The man was said to have been "scrambling", described as a climbing and hiking activity.
North Berwick Lifeboat was launched after the report of a casualty on rocks near the harbour.
An RNLI spokesman said its crew and paramedics from the Scottish Ambulance Service arrived on the scene within minutes.
A Royal Navy helicopter was called because of the dangerous position in which the man was found.
The man was winched from the rocks and taken to Edinburgh Royal Infirmary at around 6pm on Tuesday.
The RNLI spokesman said: "This was a textbook multi-agency response with good team work and communication from all involved."
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