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Phoebe Darton from Coventry was four when she was playing on a swing and got her neck tangled in the rope.
Older brothers William and John, who were also playing in their back garden at the time, realised something was wrong and ran to tell their mother.
Phoebe's mother Kate ran to get her down from a hanging position and began CPR. Her screaming alerted a nurse at the care home next door who rushed out to help.
The boys dialled 999 and stayed on the phone until an ambulance arrived.
William raised the alarm after his sister stopped responding to him while they were playing.
Kate remembered the events of the day and said: "She’d managed to get trapped inside the rope and one loop was around her neck so tight she’d lost consciousness. The blood vessels had burst in her face and she was covered in bruises."
Pheobe was then taken to hospital and was kept in a coma for two days. She made a full recovery and is now aged five.
The three children received bravery awards at a West Midlands Ambulance Service ceremony.
William said: "I feel very proud of what I've done. I was proud to get the award, too. It’s my very first one."