Please help me with the punctuation in these two sentences.
1. When first seen in the emergency room the patient was pale, slightly dyspneic at rest, and otherwise in no acute distress.
I want to put a comma in between "room" and "the" since I pause at that point when reading the sentence. Would that be correct?
2. X-ray showed a nondisplaced fracture, minimal degenerative joint disease, and arthritic changes right upper extremity.
I believe that I need a comma between "changes" and "right" but with the preceding list, I'm not so sure that it's a comma that would be used here, maybe a dash....