To our knowledge, National Institutes of Health (NIH) roughly classified hydrofluoric acid burns into three categories, based on the concentration of hydrofluoric acid (<20%, 21–50%, and >50%). This classification method regards the acid concentration as the exclusive index, without concerning the burn area and location, duration of contact, accompanying injuries and so on, hence its usage is very limited. In addition, the grading system of acute poisoning developed by Persson et al. is also used by some researchers to evaluate the HF poisoning. However, this scoring system designed is very complicated, and lacks pertinence for HF injuries. Hence this classification system is usually employed for the statistics and analysis of clinical data.

Due to the particular characteristics of  hydrofluoric acid, this chemical, no matter gaseous or liquid states, has the great potential to cause mass casualties or disasters in a very short period.Maybe the current shortage on classification of hydrofluoric acid burns directly affected the on-site and in-hospital triage in this accident. However salvage and triage is one of the most important aspects to direct technical and medical relief especially for mass casualties and disasters. It could be better if the authors can present some thoughts and suggestions on this aspect of triage. 

Chemical burns can be very different form thermal burns. The latter can be diagnosed and triaged according to the standard guidelines, while the chemical burns could be more complicated. Especially for hydrofluoric acid burns, small burned area can cause chemical poisoning and even death. Hence the immediate decontamination and early treatments are emphasizedAll of these indicated that the cardiovascular system could be the trigger organ of hydrofluoric acid  poisoning. In our opinion, further analysis on the clinical materials of these fatal cases can potentially facilitate better understanding the pathophysiological process and injury mechanisms of hydrofluoric acid injuries. We are looking forward to the researchers’ further work in this field.