An 87 year-old female was brought to the hospital with sudden confusion, trouble speaking, trouble walking, dizziness, loss of balance and severe headache for the last 3 hours. She was diagnosed with acute ischemic stroke and was started on tissue plasminogen activator (tPA) IV infusion. After a few minutes, the patient started to develop a swollen face, swollen tongue, swollen lips, low blood pressure, a weak, rapid pulse and difficulty breathing. Suspecting anaphylaxis, you administered epinephrine, antihistamines and steroids. However, she was not responding to these measures and her distress only worsened with time. Ninety minutes later, you checked her serum tryptase level, which is normal. What is the next best action in her management?
