Washington ? Beating the heat is largely a matter of taking simple precautions. Yet every summer brings preventable deaths.

Some make dramatic headlines, such as the Michigan mother charged with murder after her two children died in her sweltering car allegedly as she had her hair styled, or the football players who died last summer of heatstroke.

But those most at risk of dying from heat suffer silently, out of sight: the poor and elderly who can neither afford air conditioning nor get to a cool place during a heat wave.

Others who suffer heat illnesses often are the overenthusiasts who keep exercising despite early symptoms, the chronically ill who are more vulnerable to soaring temperatures, and children whose bodies don’t regulate heat as well as adults’.

“We know what kills people with heat, and we know what people need to do to avoid this,” says Michael McGeehin of the Centers for Disease Control and Prevention, which this week issues its annual precaution reminder.

Yet “it’s a constant struggle” to get out that message, McGeehin said.

Heat exhaustion is the most typical problem: heavy sweating, paleness, muscle cramps, weakness, dizziness, headache, nausea or fainting. Unrelieved, it can lead to more severe heatstroke characterized by red, hot, dry skin, rapid pulse, confusion or unconsciousness that can kill or cause brain damage without prompt treatment.

Death and injury

Even in years without a major heat wave, on average 200 people die from excessive heat, the CDC says. It’s too early to predict how bad this summer will be.

That’s not counting deaths from heart attacks or other illnesses worsened by heat’s stress. Nor does it count repeated sunburns that lead to skin cancer later in life.

Then there are the 73 Americans a year who die from lightning strikes and another 300 injured, many who lose eyesight or memory or suffer another lasting disability.

Ahead of summer storms, the American College of Emergency Physicians just published the first lightning safety guidelines to fight myths that contribute to that toll, such as that victims are electrically charged. They aren’t, so it’s safe to touch them and provide lifesaving CPR.

Take precautions

These are pretty grim messages to kick off what’s for many a fun-in-the-sun holiday weekend. But precautions are fairly easy. On CDC’s list:

Don’t wait until you feel thirsty everyone needs to drink more fluids, without dehydrating caffeine or alcohol, on hot days regardless of activity levels. During heavy exercise in high heat, drink 16 to 32 ounces an hour.

Limit outdoor activity to morning and evening. Wear wide-brimmed hats, sunglasses and sunscreen.

Stay in air conditioning. Once the temperature hits the high 90s, fans won’t prevent heat-related illnesses. Try a cool shower or visit an air-conditioned library or shopping mall.

Never leave anyone, especially children, inside a closed parked car for even a few minutes. The sun turns parked cars into greenhouses, and temperatures inside can soar in 10 minutes to a deadly 140 degrees.

As for lightning, it can strike up to 10 miles away from a thunderstorm, so when thunder is heard, stop the ball game or picnic and seek shelter immediately, says John Jensenius of the National Weather Service. Wait 30 minutes after a storm passes before returning outside.

Also among the guidelines:

Large buildings, like houses, are the safest structures, followed by cars, buses and trucks just don’t touch the metal. Avoid trees, poles, open fields and open structures such as sheds, baseball dugouts, gazebos or golf carts. Get away from water.

If you’re camping or otherwise can’t get inside, don’t lie on the ground or huddle in a group; a lightning strike could hit more than one person. For those in the open, Jensenius advises squatting on the balls of the feet.

All large outdoor gatherings, such as sporting events, need lightning evacuation plans.