A man is understood to be in a critical condition after being airlifted off the Isle of May on Thursday evening.
Both the all-weather and inshore lifeboat from Anstruther were tasked by the UK Coastguard at 5.18pm following reports that an elderly man had suffered a stroke on the island, which is five nautical miles east of the Fife fishing village.
The crew administered oxygen and assisted with the care of the casualty while the Coastguard’s search and rescue helicopter made its way to the scene from its base in Prestwick.
The man, who is thought to be 73-years-old, was taken to Edinburgh Royal Infirmary for further treatment.
Anstruther RNLI station coxswain Michael Bruce said: ‘With reports of the casualty having potentially had a stroke, it was key that we made our way to the scene as quickly and as safely as possible.
“With the helicopter based some 90 miles away in Prestwick, it was key to have our all-weather lifeboat on the island as a secondary evacuation option.
“Gladly, the helicopter was available and was able to assist the gentlemen with transfer to hospital for further care.”
The lifeboats returned to station and was made ready for service around 7pm.
No further details on the man or his condition have been released