A teenage boy has been airlifted from the Isles of Scilly after sustaining serious head injuries when he was thrown from a horse-drawn cart.
The 15-year-old was injured on Bryher on Tuesday when he was thrown and hit his head on a wall.
He was taken to the Royal Cornwall Hospital at Treliske by a search and rescue helicopter, and then transferred to Frenchay Hospital in Bristol.
The boy also sustained spinal injuries. His condition is not known.
Emergency volunteer responders were praised for their part in the operation.
The islands' ambulance co-ordinator and ambulance technician, Tony Smith, said the work of responders meant he could concentrate on treating the boy.
He said: "Half of our responders on the islands are 'multi-hatted': they're also either firemen or coastguards. In this case we had two volunteer coastguards who were also community responders.
"They communicated with the helicopter, gave grid references and laid down landing smoke, taking the pressure of me so I could carry on treating the patient."