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A 32-year-old woman develops widespread urticaria, lip swelling and wheeze within 15 minutes of eating a satay dish at a restaurant. On arrival of paramedics her blood pressure is 86/50 mmHg and heart rate 124/min. She is laid supine with her legs elevated, given high-flow oxygen, and 500 micrograms of adrenaline is injected into the mid-outer thigh. Five minutes later she remains wheezy, and her blood pressure is 88/54 mmHg. Which one of the following is the most appropriate next step in management?

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