Some patients can be discharged from the ER with PCP follow up.
Evaluate for ability to care for at home and possible need for placement
If<unk>  is severe or refractory to treatment, consider goals of care discussions and a hospice referral
Failure to thrive
Chronic or recurrent infections
Stridor 
Immunodeficiency
Stridor
Endocrine disorder
Hiccups
Cancer