One lead off

This may be a stupid question, but one of my patients HR showed in the low 20, however 1 of the 5 leads was off. Is it a true heart rate or not?

No. Just like it can show a rhythm other than what the heart may actually be in. Sometimes a-fib or other crazy rhythms are shown when leads are too close together too. For accuracy all the leads need to be on and properly placed.

What?

^^ lol

This may be a stupid question, but one of my patients HR showed in the low 20, however 1 of the 5 leads was off. Is it a true heart rate or not?

I've never heard of that. I would think it wouldn't show a heart rate at all if a lead is off. You can always check the HR manually, re-attach the lead and compare. Could just be a faulty EKG machine

Depends upon which lead was off. Most rhythms can be accurately detected with 3 leads - that used to be the norm for continuous monitoring, even in ICU.

Might depend which lead was off, but, use your eyes to count complexes if you question the machine.

Don't forget, the EKG only shows electric activity. It does not tell you if the activity is perfusing. Take a pulse.

Your machine could read a rate of 60, but you might find a pulse of 20 if they have bigeminal PVC couplets.

Did you assess your patient? What did they look like? This is why you need to assess your patient and treat, not assess and treat the monitor. I would expect a patient with a HR of 20 to look very sick because they aren't perfusing very well with that rhythm. In regards to the leads, everyone gave good advice here.