What is one of the critical steps in managing refractory anaphylaxis apart from administering adrenaline?

In the management of refractory anaphylaxis, providing high flow oxygen is vital as it addresses the potential respiratory compromise that may arise due to airway swelling or bronchospasm associated with anaphylaxis. High flow oxygen can help ensure adequate tissue oxygenation, especially if the patient is experiencing hypoxemia due to airway obstruction or severe bronchoconstriction. This step is essential in any anaphylaxis protocol, particularly when the initial treatment with adrenaline is insufficient to reverse the reaction or if the patient displays signs of hypoxia.

While other options may support treatment, they do not directly address the immediate need for adequate oxygenation or respiratory support, key components in the management of a life-threatening allergic response.