How to Set Up a Quarantine or Hospital Tank for your Reef Tank


One of the worst things that can happen to you in the reef tank hobby is to have your fish come down with a parasitic infection like Ich or Marine Velvet and slowly seeing the illness make its way from fish to fish. The result can be the slow death of your fish where some make it and some don’t. 

Many parasites have a life cycle that moves from the incubation in the tank’s substrate, to infection inside your fish, and back into the substrate for incubation and reproduction. This never-ending cycle can take place in a reef tank and each cycle increases the probability that your fish will succumb to infection.

The only way to stop the vicious cycle in your reef display tank is to prevent it from starting in the first place or eradicating from the display tank when it rears its ugly head. To accomplish this task, the use of a quarantine hospital tank is a great asset to have and utilize in your reef keeping journey.

When I purchased my 210-gallon reef tank it came with a full stock of fish, live rock, and coral. The tank had been in service for a couple of years and was well established. I successfully moved the tank into my home and had it up and running for a few months and noticed that the fish would regularly get outbreaks of Ich. Most of the time the fish fought through the parasite without issue, but it would come back now and then and I did have a few losses. I also didn’t have the best success rate when adding new fish to the tank.

Some people just live with Ich in their reef tanks and keep the other variables like fish health and water quality in check to allow their fish to normally fight through fish sickness and infections that may happen. Some reefers also can go years in hobby adding fish without quarantining by sheer luck have parasite free systems. I, however, felt the need to do what I could to eradicate the fish parasites from my tank and quarantine moving forward to achieve greater long-term success.

Eradicating the parasites from the tank required medication treatment for the fish and had to be done outside of the display tank as most medications are not reef safe for coral and inverts. This meant that I had to set up a separate saltwater hospital tank to treat the fish. There are other methods out there including medicating in tank with “reef safe” medications but generally these have mixed results and can put your display tank at risk. The most surefire way to eradicate parasites from the tank is to use a hospital quarantine tank.

Once the parasites are out of the fish and killed, any infestation in the display tank naturally takes care of itself. The parasites hatch and then starve because there are no hosts to feed off with the fish removed. This process takes about 10 weeks to complete.

The nice thing about setting up a hospital tank is the ability to convert it to a quarantine tank when looking to add new fish. Read on to learn about how I set up my hospital and quarantine tank to support my reef tank.       

Equipment Needed to Set Up a Hospital Quarantine Tank

A quarantine tank can be very basic and only limited equipment and cost are necessary to keep your fish alive and thriving before moving them into your display tank. For my set up I keep it pretty basic and I will list out everything that I use. Some of the items below are optional but can help with the success and ease of maintenance with a hospital quarantine tank. 

Optional

How to Choose the Right Size Quarantine Hospital Tank

Choosing the right size tank will come down to the task you trying to accomplish with the hospital quarantine tank. If you already have a disease-free tank and you are looking to quarantine only when adding a new fish here or there a smaller tank will do. I like a simple 20-gallon long tank that can be found relatively cheap and easy for routine fish add quarantine.  

In my case, I had 10 fish my 210-gallon reef tank that I needed to house in the hospital tank so I needed a larger tank. I just so happened to have an extra 40-gallon breeder tank sitting unused that worked perfectly for this task.

The nice thing about going larger is if you aren’t housing that many fish in quarantine you can simply not fill up the tank entirely to save on salt and water changes. Another advantage with a larger size is more water volume and more of a chance to catch ammonia spikes before it hits lethal levels.  

How to Oxygenate the Water in a Quarantine Hospital Tank

One of the most important aspects of the well-being of your fish in the hospital tank is to ensure that gas exchange is happening so that your fish can breathe. Without this, your fish will run out of oxygen and die usually in a matter of hours.  

Gas exchange in normal reef tanks happens at various points in the movement and filtration of the water moving through the system. Some common points are the point where water moves from the display to a sump and other points where water moves through the air. Surface agitation and the skimmer are also points where water is oxygenated.

A hospital tank typically has fewer oxygen exchange points, so you have to make sure it is happening inside the tank. My preferred way to do this is to use a simple air pump with airline tubing, connected to an air stone. This provides good oxygen exchange and provides a little bit of flow in the water.

Another option is to use a powerhead. As the powerhead creates movement in the water it can cause surface agitation and gas exchange.

Is Water Flow Needed in a Hospital Quarantine Tank?

High water flow is generally not necessary in a hospital quarantine tank. I like to think that a calm tank with the least amount of variables works well with getting a fish through quarantine and medication when used. I find that the use of an airstone and air pump is that is needed.   

However, there are fish in the reef tank hobby that prefers high flow. In those cases, adding a powerhead is not an issue. Another advantage of including a powerhead is that it can help keep food suspended in the water column to be eaten by fish or picked up by a filter if used. Using a siphon to clean out uneaten food and waste is another option.    

ReefSumper Recommended Powerheads

Choosing the Right Heater for a Quarantine Hospital Tank

Choose the appropriately sized heater for the size of your quarantine hospital tank. A starting rule of thumb is to choose a heater in the range of 2.5 – 5 watts per gallon of water in the tank. You can adjust up or down the rule of thumb depending on where your tank is going and the relative room temperature it is in the room. One thing I like to have on hand is extra equipment in the case that something fails on my display tank. Big temperature changes can mean doom to a reef tank in short order. With that in mind, I use the exact model of the heater that my display tank uses on my hospital quarantine tank so that I have a back for my display’s heater in the case that I need it.

ReefSumper Recommended Heaters

As stated, one of the most common and devastating events is a broken heater, especially if it gets stuck in the on position. If this happens high water temperatures can melt down a tank and kill its inhabitants in a matter of hours. One device to consider is the Ink Bird Temperature monitor. These work by measuring the temp of the tank water and cutting power off the heater if it exceeds specified ranges. On my display tank, I use a Neptune Apex controller and on my hospital quarantine tank, I use the Ink Bird to monitor the temperature.  

Inkbird ITC-308 Digital Temperature Controller 2-Stage Outlet Thermostat

C-308 is an easy-to-use, safe and reliable dual relay temperature controller.

Most quarantine hospital tanks are only used for a short time and if you are using a quality heater like the Eheim Jaguar the chance of a heater malfunction going unfound should be small. If your’re willing to take the chance you can but I recommend using a temperature monitor so you can see on-demand the temperature of your tank. I like to use digital temperature monitors like this one. 

Eheim 3619090 Jager Aquarium Thermostat Heater

Precisely regulated, constant water temperature is very important for the comfort and success of your aquarium inhabitants. The Jäger TruTemp adjustable heater is an ultra-modern electronic thermal device offering today’s best technology.

How to Provide Hiding Places for Fish in a Quarantine Hospital Tank

Giving your fish hiding spots can be beneficial to get them acclimated to the quarantine tank. 

It also will help if you are quarantining multiple fish when some are on the aggressive side. The most popular items to use for providing hiding places for your fish in the quarantine hospital tank are PVC fittings. PVC is great for this as they are easily found at any home development store and comes in many shapes and sizes. Look to purchase various sizes depending on the size of the fish you will keep in the quarantine hospital tank. I like to use elbows, tees, and drain-out fittings. 

You can even stack fittings to make intricate hiding places for your fish. PVC is nonporous and will not retain medications used in the quarantine hospital tank so they can be rinsed and reused.  

Should You Use Live Rock and Sand in a Quarantine Hospital Tank

I do not use live rock and sand in my quarantine hospital tank. I only use my quarantine hospital tank when needed and break it down in between. If you are going to keep a quarantine hospital tank up at all times it can be beneficial in the sense that you would always have a cycled tank ready and not have to worry about ammonia in the nitrogen cycle. Another time you might want to have sand and rock is for a fishless quarantine hospital tank. Certain hitchhiking parasites can come on coral, inverts, and water droplets from external sources.

A fishless hospital quarantine tank can be used for coral and inverts before they move to the display tank as prevention. Keeping live rock and sand in these tanks can be ok as the parasites will starve with no fish host.

Live rock is very porous and can absorb medications used in the hospital quarantine tank so you want to make sure you never transfer to your display rock or sand that has been exposed to medication in the quarantine hospital tank. If you are going to use rock or sand make sure to remove it before medicating. 

Does a Hospital Quarantine Tank Need to be Cycled?

A hospital quarantine tank does not need to be cycled to hold fish. With that said, there will be little to no bacteria colonization in a new hospital quarantine tank and thus no way to convert ammonia. Ammonia, even in small amounts is lethal to fish. To prevent a spike in lethal ammonia you must keep track of the ammonia level and when ammonia increases look to reduce it through a water change or the use of an ammonia reducer. I like to use Seachem’s Ammonia Checker at all times on my hospital quarantine tanks. The checker suction cups on the inside of the tank and gives a quick visual of the current ammonia state in the tank allowing you to take action if it is high.  

Seachem Ammonia Checker

Ammonia Alert is an innovative color indication device for continuously detecting and monitoring toxic free ammonia. There’s no need to wait for signs of stress or death in your fish or corals to take action against an ammonia spike.

Is a Filter Necessary for a Quarantine Hospital Tank?

A filter is not 100% necessary on a quarantine hospital tank, but it does have its advantages and I like to use one on my hospital quarantine tanks. I use a simple freshwater hang on the back style filter. The one that I’m currently using is the aqua clear filter and it works great. Having a filter allows you to pick food and waste particles before it is broken down and degrades water quality. The filters sponges and pads in the filter can also be used to seed bacteria in your hospital tank.

AquaClear 50 Power Filter

The AquaClear 50 Power Filter features a unique multi-stage filtration system that provides complete mechanical, chemical, as well as biological filter media for superior water quality.

If you have some time, you can leave a few of the pads in your display tank or the display tank sump to seed with helpful bacteria. When you are ready to use your quarantine hospital tank simply put the sponges in your filter and you will now have some starter bacteria to help cycle your tank. Make sure to not move filters back into your display tank if you’ve medicated.

Other Items to Consider for a Quarantine Hospital Tank

A light source: Any old light source will work for a quarantine hospital tank. On mine, I use a simple Marineland led strip light that I had sitting around. I turn it on manually around the time my display turns on and off at the same time as the display.  

Marineland LED Strip Light, For aquariums, With Adjustable Mounting Legs

Marineland LED Strip Lights provide the ultimate opportunity to create a realistic underwater home-aquarium environment. This all-new line of LED lights is 20% brighter and is designed for reliable, long-term performance. 

A cover for the top of the aquarium: I like to make my covers using screen frames from home development stores and netting that can be found online. Egg crate is another option as an effective top for your tank. Glass also works well if one is available for your size of the tank. Glass also helps reduce the amount of daily evaporation.  

Power strip: Like any other reef tank, you’ll need plugs and a solid power strip with surge protection is always a good idea to have for your hospital quarantine tank. Here is the one I use on my 210 gallon reef tank.  

Belkin Surge Protector Power Strip w/ 8 Rotating & 4 Standard Outlets

Turn 1 outlet into 12 surge-protected AC outlets with a compact power extension cord with 8-foot cable. Designed with 8 rotating outlets and 4 widely spaced stationary outlets, as well as an efficient cord-management system.

My Hospital Quarantine Tank Results

After setting this hospital tank up I moved all of my fish to the tank conducted two rounds of copper treatment using Seachems Copper. All of the fish made it through quarantine and made it back successfully to the 210. I still use this setup when adding new fish. I’ve only added fish here and there and I use about half the water in the 40-gallon breeder. Since eradicating the parasites and implementing a strong quarantine process for new fish I haven’t seen a spot of ich, cloudy eyes, or any other sickness signs the fish just seem to be fat and healthy.

Nothing is worse than visibly seeing your fish sick and dying one by one. A quarantine tank greatly reduces your risk of this and is one of the best investments you can make in the hobby. Don’t wait on setting one up until it’s too late.   

ReefSumper

Hello, I'm ReefSumper. Thanks for checking out my site! I've been in the hobby for over 10 years and enjoy reef tanks immensely. I set this site up to provide fellow refers with battle-tested information to help you set up and maintain an efficient, healthy, and amazing reef tank.

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