Consider the quaternions $\Bbb H = \mathrm{span}\{1,i,j,k\} \simeq \Bbb R^4$, which is nothing else but $\Bbb R^4$ endowed with the algebra structure given by $i^2=j^2=k^2=ijk=-1$.
For $q= a+ib+jc+kd\in \Bbb H$, we define its conjugate $\bar{q}=a-ib-jc-kd$ and its real part $\mathrm{Re}(q) = a = \frac{1}{2}(q+\bar{q})$.
The usual inner product on $\Bbb R^4$ reads $\langle q_1,q_2\rangle = \mathrm{Re}(q_1\bar{q_2})$, and the associated norm is $\|q\| = \sqrt{q\bar{q}}$.
One readily checks that the product in $\Bbb H$ satisfies $\overline{q_1q_2}=\bar{q_2}\bar{q_1}$ and $\|q_1q_2\| = \|q_1\|\|q_2\|$.
Moreover, if $q\neq 0$, then $q$ is invertible and $q^{-1} = \bar{q}/\|q\|^2$.
The set of purely imaginary quaternions is $\mathrm{Im}(\Bbb H) = \{q \in \Bbb H \mid \mathrm{Re}(q) = 0\} = \mathrm{span}\{i,j,k\} \simeq \Bbb R^3$.
Identify $S^3$ with the set of unit length elements in $\Bbb H$.
For $u\in S^3$, consider the conjugation by $u$
$$
i_u\colon q \in \mathrm{Im} (\Bbb H) \longmapsto uq\bar{u}\in \mathrm{Im}(\Bbb H)
$$
(I leave you as an exercise that $i_u(q)$ is indeed in $\mathrm{Im}(\Bbb H)$ if so is $q$. Hint: show that $i_u$ stabilizes $\Bbb R = \mathrm{Im}(\Bbb H)^{\perp}$, and that it is an orthogonal map).
Then $i_u$ is a linear endomorphism of $\mathrm{Im}(\Bbb H)$ satisfying $\|i_u(q)\| = \|q\|$ for all $q$.
Moreover, $i_{u_1u_2} = i_{u_1}\circ i_{u_2}$.
In other words, we have defined a group homomorphism
$$
i \colon S^3 \longrightarrow O(\mathrm{Im}(\Bbb H)) \simeq O_3(\Bbb R).
$$
From its definition, $i$ is a continuous map (between Lie groups, which are in particular topological spaces), and $S^3$ is connected.
It follows that $i$ has range in the connected component of $id\in O_3(\Bbb R)$, that is, we have a continuous group homomorphism
$$
i \colon S^3 \longrightarrow SO_3(\Bbb R).
$$
To conclude, it suffices to show:
- that $\ker(i) = \{\pm 1\}$,
- and that $i$ is surjective.
Indeed, in this case, we would have $SO_3(\Bbb R) \simeq S^3 / \{\pm 1\} = \Bbb RP^3$.
We show the first point.
Assume that $i_u = id$ with $u\in S^3$.
Then $i_u(q) = q$ for all $q \in \mathrm{Im}(\Bbb H)$ implies that $u$ commutes in particular with $i$, $j$ and $k$.
Playing with the anti-commutation properties of $i$, $j$ and $k$ then shows that $u$ has to be real.
Hence, $\ker(i) \subset \Bbb R \cap S^3 = \{\pm 1\}$.
The reverse inclusion is clear.
Finally, let us show that $i$ is surjective.
For $SO_3(\Bbb R)$ is generated by the rotations of angle $\pi$ (that is, orthogonal maps that fix some axis and induce $-id$ in its orthogonal plane), it suffices to show that such maps are attained.
Let $P = u^{\perp}$ be a plane in $\Bbb R^3 \simeq \mathrm{Im}(\Bbb H)$, with $u \in \mathrm{Im}(\Bbb H)$ satisfying $\|u\|=1$.
From $u^2 = u(-\bar{u}) = -\|u\|^2 = -1$, one has
$i_u\circ i_u = i_{u^2} = i_{-1} = id$.
Moreover, one checks that $i_u(u) = u$, so that $i_u$ fixes the axis $u^{\perp}$, and hence the plane $u^{\perp}=P$.
Ultimately, $u\notin \ker(i)$, so that $(i_u)|_P \neq id_P$, and one thus has $(i_u)|_P = -id_P$.
It follows that $i_u$ is the desired rotation of angle $\pi$ in $P$, and that $i$ is surjective.
Remark 1: for surjectivity, we could have done the following instead.
Since $S^3$ is compact, so is its image by $i$, which is then closed.
By connectedness of $SO_3(\Bbb R)$, it suffices to show that the image of $i$ is open.
By group homomorphism properties, it is sufficient to show that $i$ is open near the identity $1 \in S^3$.
This latter fact follows from a direct application of the inverse function Theorem.
I leave it as an exercise.
Remark 2: we have in fact shown that $SO_3(\Bbb R)$ and $\Bbb R P^3$ are isomorphic as Lie groups.