"whats really so bad about giving someone lasix when it turns out they have bi lat Pneumonia?
On the rare occasion that I give albuterol, I use both oxygen trees and place the patient on a NC @ 4 LPM along with the handheld nebulizer, since a tired CHFer spends a lot of time with the inhaler away from the face. My service is late into the CPAP game (we're implementing it in the next 30 days) but it seems to me that NTG and CPAP is the way to go. It should also go without saying that new onset pumonary edema should be treated as a possible ACS until proven otherwise.
One thing that's missing from this thread is the mention that most CHF patients are not hypervolemic. That used to be the justification for use of Lasix: a pt with a bunch of fluid in his lungs obviously needs to have fluid taken off. But since we've gradually discovered that this isn't true--most CHF pts are euvolemic (and occasionally hypovolemic), even if you ignore the risk of misdiagnosis there's no reason to dehydrate everyone indiscriminately.