A 78-year-old woman in a care home is noted to be acutely confused and drowsy. She has a productive cough and has been febrile for 24 hours. On examination her respiratory rate is 28 breaths/min, blood pressure 94 over 56 mmHg, pulse 112 beats/min, oxygen saturation 90 percent on room air and temperature 38.7 degrees Celsius. Her NEWS2 score is 8. What is the most appropriate immediate action