San Miguelito
San Miguelito: hospital, how to check ducts without closing emergency
A hospital has no free day. Each ward is checked in small batches, and whatever stays unseen is written down instead of forced.
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The ducts of a San Miguelito hospital are checked ward by ward, in small batches that leave each area without work for a few hours while the rest keeps running. Emergency and critical areas are agreed separately with the infection committee. Access is from outside the rooms, and whatever the protocol does not allow to be checked is recorded as not reviewed.
A public second level hospital like those of San Miguelito runs twenty four hours, every day. There is no quiet Sunday and no week of recess. While nurses in an internal medicine ward finish their round, an ambulance arrives at emergency, and at the same time the maintenance office gets word that the air conditioning in one area is not cooling. Stopping the hospital to check its ducts is never an option.
The way out is to review in parts. In a compact district like San Miguelito, where the hospital serves far more people than the size of the territory would suggest, sectorization is what lets the work move forward without care coming to a halt.
How is a hospital divided to check its ducts without closing it?
It is divided according to how the air system is built, not according to what the wards are called. Each air handler serves one or several areas, and that relationship is requested from maintenance ahead of time as a list. With it a sequence is built: first the areas with their own unit and less criticality, such as outpatient care or administration, and then the more delicate areas, agreed one by one with the infection committee. Each batch is limited to a few hours so that the area returns to its rhythm quickly.
The fieldwork is carried out by the Climatiza team, who check branches, grilles and air handlers and record the result in an illustrated report, also in the case of San Miguelito.
| Area | What fits with the area in use | How it is accessed |
|---|---|---|
| Outpatient care and administration | Filter, return and camera through corridor access panels | From corridors and technical rooms |
| General inpatient wards | Looking and photographing. Dust raising work is scheduled in batches | From outside the rooms |
| Emergency and critical areas | Only what the committee approves, with an escort | According to hospital protocol |
| Technical rooms and air handlers | Filters, coil and pan, with units taken in rotation | Technical staff’s own access |
Why does the way of access matter in a ward?
It matters because the way of working changes the air in the room. A 2025 paper in Infection Prevention in Practice compared two ways of cleaning ducts in a ward for immunocompromised patients. Entering from the room itself with traditional brushes, particles of all sizes rose markedly and Aspergillus spores increased slightly for about an hour. With access from outside and extraction at the point, the air in the ward barely changed. Hence the rule of entering through outside access panels.
Another study, from 2026 in the Journal of Hospital Infection, measured airborne fungi in a semitropical coastal health facility. Concentrations rose on leaving the air handler and more so at a supply register, which is consistent with contamination of the duct downstream of the filter, and dropped after the section was replaced and the surfaces cleaned. It was a single facility and the filter was not the only variable, so it is taken as a hint of why the duct is looked at and not as a promise.
Why does it matter if the hospital already has filters and protocols?
It matters because filters and protocols protect a system that, over the years, accumulates dust and moisture in places nobody sees. The CDC guide to environmental infection control notes that the air systems of a health facility require routine maintenance and monitoring, and that accumulated dust and moisture raise risk. The same guide makes clear that cleaning ducts has not been shown to prevent health problems. That is why in a hospital the frequency is set by the center’s own protocol, and the camera provides the real condition of each authorized area.
It also matters for the comfort of staff and patients in a climate of 75.7% annual mean humidity, according to ETESA, and for administrative order. A report with images per ward allows maintenance, the infection committee and management to talk with the same data.
An illustrative case, not a real client: a hospital with four air handling units. The camera shows the outpatient unit with a saturated filter and settled dust in the first section, the inpatient one with a slow condensate pan and the emergency one with no findings. The sensible decision is to take care of outpatient care in a night batch, correct the drainage of inpatient with the unit in rotation and leave emergency under watch until the next review. All of it is done without closing anything.
A practical detail is unit rotation. When a ward has two air handlers in parallel, one can be stopped for a few hours while the other holds the service, so the filter is opened, looked at and changed without affecting the area. When there is only one, the batch is scheduled in the lowest occupancy window and it is agreed with nursing what happens if a patient needs to change rooms. These decisions are the hospital’s and not the provider’s, which is why the plan is drafted with maintenance and not for maintenance.
Which mistakes repeat and what should the report contain?
The mistake of asking for a general shutdown repeats, as does entering through the room and mixing critical areas with general ones in a single document. The report should be ordered by ward, with the condition of the filter, coil and pan of the air handler that serves it, images of returns and grilles, the access panels through which the camera went in and a separate list of what was not reviewed under protocol so the committee decides whether to schedule it again. The particulars of the district are in the San Miguelito page, the rest of the areas on the site in the map of areas served and the technique in how a camera inspection is carried out. To decide what is cleaned and what is only watched, the criteria for when cleaning makes sense help.
Scheduling a review starts with a message to Climatiza, and the service page summarizes the process.
Sources
- De Waegemaeker et al., 2025, Infection Prevention in Practice: duct cleaning workflows in wards for immunocompromised patients
- Pisaniello et al., 2026, Journal of Hospital Infection: airborne fungal and particle mitigation in HVAC systems of a coastal facility
- CDC: environmental infection control in health care facilities, air
On this site
- Hospitals and clinicsHow the work is organized in this sector
- San MiguelitoThe area and its building types
- Camera inspectionThe real condition before deciding
Climatiza and Radar Panamá
Why does inspecting and cleaning ducts matter?
These are the technical reasons, with their source, why the condition of the ducts is checked before deciding. Duct cleaning has not been shown to prevent health problems according to the EPA and the CDC, and it is proposed only when the observed condition justifies it.
| Advantage | Data with source | What it means in practice |
|---|---|---|
| Anticipate the tropical humidity | According to ETESA (Tocumen station, 1977 to 2010), mean annual relative humidity in Panama is 75.7 % and rises to between 78.2 and 82.4 % in the rainy months. | The condensate pan, the drain and the coil are checked first, because that is where moisture builds up. |
| Protect equipment performance | In a laboratory test with dust equivalent to one year of use, coil pressure drop rose between 6 and 30 % and efficiency (EER) fell between 1 and 9 % (Yang, Braun and Groll, ARTI, 2004). | It is a laboratory result and not a promise of savings: it points to the components worth checking. |
| Follow a technical inspection reference | The ANSI/ASHRAE/ACCA 180 standard is the standard practice for inspection and maintenance of commercial HVAC systems. | It is an industry reference, not a legal requirement in Panama, and helps organize the review plan. |
| Keep construction dust out of the system | The EPA and NIOSH Building Air Quality guide asks to block return grilles while construction work takes place in occupied buildings. | Before accepting a new or remodeled system it is worth checking whether construction dust got in. |
Frequently asked questions
Does emergency have to close for the hospital ducts to be checked?
No. Emergency and critical areas are agreed separately with the infection committee, and whatever the protocol does not allow to be checked is recorded as not reviewed. The rest of the hospital is checked in small batches.
Why is access from outside the rooms?
Because entering from the room raises particles and spores that take about an hour to return to normal, according to a study in a ward of immunocompromised patients. With outside access panels the air in the ward barely changes.
How often are the ducts of a hospital checked?
The frequency is set by the hospital’s own protocol, not by a general rule. The camera provides the real condition of each authorized area, and the report suggests when to look again based on what was seen.
What did a study find about airborne fungi in a coastal health center?
Pisaniello and colleagues (2026, Journal of Hospital Infection) found airborne fungi rose from 1 to 22 fs/m3 on leaving the air handler and reached 387 at a supply register. After the duct was replaced and surfaces cleaned, they fell to 171. It was a single center and the filter was not the only variable.
How is an operating room or isolation room handled in a hospital duct review?
Only with the hospital’s protocol and responsible officer, and if the protocol does not allow it, it stays out of scope and is noted so in the report. The emergency department is observed with the camera at times of lower demand, without cleaning if there is no clear indication, so care is not disrupted.
Keep reading the guide
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