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Modern SMR focuses on clinical indicators rather than automatic long-board immobilization. High-risk features like midline neck pain and neurologic symptoms (paresthesias) warrant cervical motion restriction. The evidence supports applying a properly sized cervical collar, providing manual in-line stabilization during movement, and facilitating careful self-extrication or assisted movement to a stretcher with head-of-bed immobilization devices as locally approved. Long backboards are primarily extrication tools and may increase discomfort, pressure injury, and respiratory compromise if used routinely; many systems avoid transporting on backboards unless necessary. Option A ignores clear high-risk indicators. Option C over-immobilizes without added benefit and may cause harm. Option D is inappropriate; EMTs do not obtain radiographic clearance in the field. Continue to reassess neurologic status, pain, and circulation-motor-sensation (CMS) in the extremities, and expedite transport to an appropriate facility, notifying the receiving hospital about mechanism and neuro symptoms.