Actions of the familiar card

Sorry if this is a question with an obvious answer. Every Familiar card begins with the kill icon. In the book I was confused as if this means that every time a healthy familiar is flipped that the immediate action kills that card then resolve the after effect (essentially making the familiar cards impossible to evacuate, as they'd constantly be going from the crowd to faced up and killed and put into the population discard pile). Or does this mean I have to choose another card to kill (and then resolve the after effect). Also, can the killed card be face down or does it have to already be face up? Thanks for any clarification.

The skull icon only triggers when cards are killed.

"Flip face-up" effects are only relevant to cards with the icon. Cards without that eye icon have no effect upon being flipped face-up.

The icon means that whenever that card is killed (whether face up or face down) you carry out the effect to the right.

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